Why Is Opioid Trouble in Later Life Rising So Sharply?

Ask anybody to picture the opioid crisis and the picture arrives almost fully formed. It is somebody young, somebody in a city, somebody in a doorway. A report released in Ontario last week makes the case that the picture is missing an entire generation, and that the missing generation is the one sitting at home with an unexamined repeat prescription nobody has looked at in nine years.

About one in every 350 older Ontarians is now identified as living with opioid use disorder, an increase of 81 percent since 2017. The short version is that opioid trouble in later life is climbing steadily while public attention remains fixed somewhere else entirely, and that the practical consequence for most families is a medication review that never quite gets booked.

The findings come from the Ontario Drug Policy Research Network report published through Unity Health Toronto, and the most interesting thing about them is where they point. Not at anything that started recently. At prescribing decisions made in the 1990s, catching up with the people who received them.

Key takeaways

The number of Ontarians aged 55 and over with health care interactions related to opioid use disorder rose from 7,116 in 2017 to 15,231 by the end of 2025.

That works out to roughly one in every 350 older adults in the province, an increase of 81 percent across the eight-year window.

Ontario recorded 1,087 opioid toxicity deaths among older adults across 2023 and 2024 combined, which is close to one death every single day.

Seventy-eight per cent of the deaths associated with opioid use disorder happened in people's own homes, sometimes with nobody else present.

Report author Tara Gomes heard consistently that long-term care homes lack the staffing to supervise treatment doses safely for residents with complex needs.

What Do the Ontario Numbers Actually Show?

The report tracked older adults across Ontario between 2017 and 2025, and the line on the graph does only one thing across those eight years. The number of adults aged 55 and up with health care interactions related to opioid use disorder more than doubled, climbing from 7,116 people to 15,231.

Deaths climbed alongside the caseload rather than levelling off as treatment expanded, and reporting on the release by CTV News notes 1,087 opioid toxicity deaths among older Ontarians across 2023 and 2024 combined. Tara Gomes, the epidemiologist who authored the report, described a consistent climb not merely in rates of the disorder and of treatment, but in opioid-related harm right across these older age brackets.

Why Is This Happening Now the Wrong Question?

The instinct is to look for something that changed recently, and there is nothing much to find. Opioids were prescribed at high rates across North America through the 1990s and early 2000s, and when those prescriptions were scaled back through the 2010s, a proportion of the same patients moved across to the illicit supply rather than simply stopping.

Gomes has put it plainly in her interview with The Globe and Mail, pointing to people first exposed to prescription opioids decades ago who are now aging into their fifties and sixties and arriving in the health system with genuinely complicated needs. She also notes that part of the measured increase reflects better awareness and screening, which means cases that previously went uncounted are finally showing up in the data.

That pattern of late recognition is not unique to opioids, and the same blind spot shows up in our coverage of what older adults are rarely asked about cannabis, where the assumption that substance questions belong to younger patients does most of the damage.

How Does an Aging Body Change the Picture?

If you are an older adult managing pain, or you help care for a parent who is, none of this is a reason to panic about an existing prescription. It is a reason to treat the medication review as something that actually gets scheduled rather than something everybody agrees is a good idea and nobody books.

Dr. Samir Sinha, who documented a similar national trend in a 2023 report for the National Institute on Ageing, has explained that bodies handle these drugs differently with age. Older adults metabolize medication less efficiently, and because many are already taking several drugs for chronic conditions, the risk of interaction rises alongside the risk of an emergency department visit, which is one reason opioid trouble in later life appears in hospital data long before it appears anywhere else.

His earlier report found that older adults carry the highest rate of prescription opioid consumption in Canada along with the highest rates of overdose, side effects and death. Chronic pain is almost always the starting point, and our guide to why joint pain changes as you get older covers the alternatives worth raising before anyone reaches for a stronger prescription.

Why Does Where These Deaths Happen Matter So Much?

The setting turns out to be the argument rather than a detail attached to it. Gomes heard clearly from the field that long-term care homes are understaffed and may lack the people required to supervise treatment doses safely for residents with more complicated needs.

The risk does not disappear when somebody stays in their own home either, because the report found that 78 percent of deaths associated with opioid use disorder happened in people's own residences and sometimes in isolation. Access to treatment beds and specialist support is the constraint underneath all of it, which our reporting on the long wait for psychiatric beds across Canada set out earlier this summer.

How Do You Go About Asking for a Medication Review?

The practical advice from the researchers is unglamorous and genuinely effective, and it takes one appointment rather than a campaign.

Bring every single product to the appointment. Prescriptions, over-the-counter medication, supplements and anything left over from a previous illness.

Ask whether the dose still makes sense today. A dose that suited somebody at 55 frequently does not suit the same person at 72 with two new conditions.

Ask specifically about interactions. The combination matters more than any single drug, and combinations accumulate unnoticed across years of separate appointments.

Ask what the plan is beyond the prescription. Physiotherapy, movement and other medication classes are worth exploring before a dose goes up rather than after.

Ask a pharmacist about a take-home naloxone kit. Kits are free at most pharmacies across Canada, and the pharmacist will walk any household member through using one.

If a parent lives alone, check in about their medication the same way you would check in about anything else that matters, because isolation is the factor the report keeps returning to. Strength and mobility work is one of the alternatives worth raising early, and our guide to rebuilding muscle in later life covers where to begin.

Anyone struggling with substance use can reach provincial health advice by calling 811 in most provinces, and a family doctor or pharmacist can start a treatment conversation without any referral at all. For a medical emergency, including a suspected overdose, call 911 immediately.

What Else Do People Ask About Opioid Safety in Canada?

Should an Older Adult Stop Taking a Prescribed Opioid?

Nobody should stop an opioid abruptly on their own, because sudden discontinuation can cause withdrawal and leave pain badly managed. The productive move is a scheduled conversation with the prescriber about whether the dose still fits, since opioid trouble in later life is driven far more by unreviewed long-term prescriptions than by anybody's individual decision to keep taking one.

How Often Should Medication Be Reviewed?

Most clinicians suggest a full review at least once a year for anyone taking several medications regularly, and sooner after any hospital stay or new diagnosis. Pharmacists in several provinces are funded to conduct structured medication reviews directly, which means you can often book one without going through a physician appointment first.

Are Take-Home Naloxone Kits Available Across Canada?

Take-home naloxone kits are available free from pharmacies in every province and territory, and no prescription is required to collect one. Ask the pharmacist to demonstrate the kit rather than simply handing it over, and keep it somewhere a household member could reach quickly rather than locked in a drawer upstairs.

Why Are Older Adults Missed in This Conversation?

Public messaging and clinical suspicion both skew younger, which means screening questions get asked far less often of people in their sixties and seventies. Tara Gomes has argued that better awareness and screening account for part of the measured increase, meaning some of the growth represents cases that were always there and are only now being counted properly.

What Support Exists for a Family Member Who Uses Opioids?

Provincial health lines reachable by calling 811 in most provinces can direct families to local substance use services, and a family doctor or pharmacist can begin a treatment conversation without a referral. Treatment for opioid use disorder is well established in Canada and works considerably better the earlier somebody starts, which makes the first phone call the part that matters most.

Where Do You Find a Pharmacist Near You?

If nobody has looked at a full medication list in a while, that is the single most useful thing to change this month. Medimap can show you pharmacies near you with current availability, family practices accepting new patients, physiotherapists for the pain management side and mental health providers where substance use and mood are travelling together.

Medication safety in hot weather raises a closely related set of questions we covered in our guide to medication risk during a heat wave, and the referral timelines in our reporting on specialist waits explain why the pharmacy counter is so often the faster door.

If you do one thing after reading this, make the appointment and bring the whole cupboard, because the review is the intervention here. Then follow the trail into why joint pain changes as you get older, which is where most of these prescriptions begin, and browse the rest of the reporting in the Medimap Health Hub.

Disclaimer: This article is general information and is not a substitute for personal medical advice, diagnosis or treatment. Speak with a doctor, nurse practitioner or pharmacist about your own circumstances, and if you are having a medical emergency, call 911 or go to your nearest emergency department.