Newly parsed data on drug overdose deaths provides a fresh look at one of the state’s most insidious killers, revealing older adults are disproportionately impacted by methamphetamine abuse than younger users. The disturbing statistics are a dark addendum to common consensus on substance use disorder (SUD), and necessitate a rethink of existing prevention and treatment protocols.

Conclusions drawn by a trio of University of Hawaii- Manoa researchers who pored over records from the State Unintentional Drug Overdose Reporting System — a subsection of the Centers for Disease Control and Prevention Overdose Data to Action Program — mark meth as the main substance associated with cause of death for overdose victims between the ages of 50 and 75, from July 2020 to December 2021. One hundred fifty-three deaths were recorded in this demographic, 75.8% of which were attributed to methamphetamine poisoning, according to post-mortem toxicology. That compares to 48.2% of deaths of users 14 to 49 years old.

Study statistics suggest long-term users prefer meth — 76.5% of middle-age and older people had histories of substance use — a choice that leads to pronounced and serious consequences. Of the cohort’s 50-and-older group, autopsies showed 25.5% died from cardiovascular or neurological complications, which researchers associate with chronic and long-term meth use.

Whether continued meth use was the driving cause of death or exacerbated existing problems is unclear, though 46.4% of the subgroup suffered from cardiovascular disease. Also murky are the reasons for meth use. Prior research cited in the UH study note outside influences and major life events including changes in education, work and marriage. Whatever the cause, there is an obvious need for assistance for older substance abusers.

The lethality of mid- to late-life drug use, and in particular meth, becomes more intense as users age. Unfortunately, current prevention, outreach and treatment strategies fail to target older demographics; much of the work focuses on the younger population — those who might be on controlled medications, dabbling with drugs or graduating to harder illicit substances. That must change.

“In drug addiction research, we tend to focus on people who are younger, especially youth,” said Treena Becker of UH-Manoa’s Center on Aging, one of three researchers who conducted the study. “Nationally, and not just in Hawaii, we always have youth prevention programs. We don’t want kids or young adults to do drugs.”

It is just as important to identify and limit drug abuse by older members of our community. Easier said than done, unfortunately — SUD symptoms such as dementia, anxiety and depression can be mistaken for natural pathologies in an aging population. Further muddying waters is the stigma attached to SUDs, which UH researchers say is acute in older individuals and can prevent them from seeking the help they need.

A multipronged effort is required to effectively address this newfound problem. Identification is an imperative first step. UH researchers say proper screening can play an essential role in recognizing abuse, and care providers should be capable of recognizing age-related issues and how they can affect substance use. Public engagement campaigns must also be deployed to increase awareness and reduce any shame felt by those in the throes of SUD. Efforts toward steering youth away from illicit drugs should be applied to adults in equal measure. Comprehensive treatment plans should be studied, with an eye on methamphetamine dependence in aging populations. It also would be beneficial for members of Honolulu’s Crisis Outreach Response and Engagement team to receive training on screening and treatment procedures to assist at-risk homeless communities.

Hawaii’s 65-and-older population is among the highest in the nation per capita, and residents take pride in caring for kupuna. Providing assistance to avoid death by methamphetamine poisoning certainly follows in that tradition.