• Yong-Fang Kuo, Jordan Westra, Edythe P Harvey, and Mukaila A Raji.
• Department of Biostatistics and Data Science, School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA; Office of Biostatistics, University of Texas Medical Branch, Galveston, TX, USA; Department of Internal Medicine-Geriatric Medicine Division, John Sealy School of Medicine, University of Texas Medical Branch, Galveston, TX, USA; Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: yokuo@utmb.edu.
• Am J Prev Med. 2025 Jan 30.

IntroductionThe American population diagnosed with opioid use disorder (OUD) is growing, particularly those aged ≥65 years. Less than 30% of OUD patients receive medication for opioid use disorder (MOUD), and even fewer older adults.MethodsUsing 20% national Medicare data, beneficiaries aged over 65 diagnosed with OUD in 2017-2022 were selected to assess the trend and types of MOUD use, including methadone, buprenorphine, or naltrexone. In the 2022 cohort (n=69,380), a multivariable logistic regression model was constructed to examine the factors associated with MOUD use. Analyses were performed in 2024.ResultsMOUD use among older adults increased from 4.8% in 2017, 7.5% in 2019, to 15.0% in 2022. The larger increase coincided with implementation of a new Medicare payment policy covering methadone for OUD. About 79% of OUD patients had chronic pain and arthritis; 50% had anemia, depression, or anxiety. Males, Black patients, Hispanic patients, older patients, and rural residents had lower odds of receiving MOUD. Enrollees with dual coverage from Medicaid had higher odds of receiving MOUD. Patients with alcohol or tobacco use disorders, anxiety, depression, hypothyroidism, or liver disease were more likely to receive MOUD; conversely, those with non-Alzheimer's dementia, cancer, chronic kidney disease, stroke, chronic pain, or arthritis were less likely to receive MOUD.ConclusionsThe rate of MOUD use was low in older adults. The disparity in MOUD use underscores the need for improved access to comprehensive opioid treatment programs and increased MOUD coverage. Additional studies of treatment patterns are also warranted.Copyright © 2025. Published by Elsevier Inc.

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