Overdose deaths among adults 65 and older from fentanyl mixed with stimulants like cocaine and methamphetamine have soared 9,000% over the past eight years, according to new research presented at the ANESTHESIOLOGY® 2025 annual meeting.
The study is among the first to use Centers for Disease Control and Prevention (CDC) data to highlight that older adults—often overlooked in overdose research—are increasingly part of the nation’s growing fentanyl crisis.
“A common misconception is that opioid overdoses primarily affect younger people,” said Gab Pasia, M.A., lead author of the study and a medical student at the University of Nevada, Reno School of Medicine, in a press release.
Researchers analyzed nearly 405,000 death certificates listing fentanyl as a cause of death between 1999 and 2023. Of those, 17,040 were adults 65 and older, while 387,924 were between ages 25 and 64.
Fentanyl-related deaths among seniors rose from 264 in 2015 to 4,144 in 2023—a 1,470% increase. Among younger adults, the number climbed from 8,513 to 64,694, a 660% increase.
The steepest growth was seen in deaths involving fentanyl combined with stimulants. Among older adults, those deaths jumped from 8.7% of fentanyl deaths in 2015 to nearly half—49.9%—in 2023, a 9,000% increase. For younger adults, the rate increased from 21.3% to 59.3%, a 2,115% rise.
Researchers say older adults may be particularly vulnerable to overdose because they often live with chronic health conditions, take multiple medications, and metabolize drugs more slowly as they age.
“Older adults who are prescribed opioids, or their caregivers, should ask their clinicians about overdose prevention strategies, such as having naloxone available and knowing the signs of an overdose,” said Richard Wang, M.D., an anesthesiology resident at Rush University Medical Center in Chicago and co-author of the study. “With these trends in mind, it is more important than ever to minimize opioid use in this vulnerable group and use other pain control methods when appropriate. Proper patient education and regularly reviewing medication lists could help flatten this terrible trend.”
The study also found that the spike in fentanyl-stimulant deaths among older adults began in 2020, while deaths linked to other substances remained steady or declined. Cocaine and methamphetamine were the most common stimulants mixed with fentanyl in these cases, surpassing alcohol, heroin, and benzodiazepines such as Xanax and Valium.
