Among those with drug addictions, it is kupuna — rather than youth — who are dying from methamphetamine abuse in Hawaii.
A study by researchers at the University of Hawaii at Manoa revealed meth poisoning to be the leading cause of fatal overdoses among middle-age and older adults in the state.
After reviewing a state database, researchers Gursimran Sidhu, Tiana Fontanilla and Treena Becker from UH Manoa’s Center on Aging found older adults were more likely to die from meth poisoning than their younger counterparts.
Younger people, they found, were more vulnerable to opioid-related deaths.
These findings were surprising, according to Becker, because many research efforts and campaigns against drugs are targeted toward youth.
“In drug addiction research, we tend to focus on people who are younger, especially youth,” she said. “Nationally, and not just in Hawaii, we always have youth prevention programs. We don’t want kids or young adults to do drugs.”
Based on findings, these programs also should target older adults.
Researchers examined data from the State Unintentional Drug Overdose Reporting System, which includes information from death certificates and medical examiner and postmortem toxicology reports — which is collected to help inform prevention efforts.
From July 2020 to December 2021, there were 263 drug-related deaths recorded statewide. More than half, 58.2%, involved people who were 50 to 79 years old.
Also, meth toxicity accounted for 64.3% of the deaths, compared with just 16.4% from opioid poisoning. A mix of meth and opioid toxicity accounted for 11.4% of the deaths.
Many of these older people who died had been using meth for decades, researchers found.
“People who use drugs long-term in Hawaii tend to favor methamphetamine,” said Becker in a news release, “and this trend becomes more lethal as they age.”
Apparently, she said, “meth never went away.”
Because meth is a powerful central nervous system stimulant, it can result in increased heart rate and blood pressure, putting an additional strain on the cardiovascular system. For meth users with a history of heart disease, this increases the risk of fatal outcomes.
Meth use also has been shown to cause long-lasting changes in the brain, with impacts on cognition, memory and emotional regulation.
Becker said from a public health perspective, the impact of chronic meth use on older adults is concerning.
“I’m very concerned about their cardiovascular health,” she said. “I’m also very worried about their brains because it’s in the scientific literature that in people who use meth frequently, it causes executive dysfunction.”
Some other potential impacts of meth, said Becker, are the desire for immediate gratification, which can lead to risky behaviors.
Researchers said it is important for health care providers to be aware of the higher rate of chronic meth use among older adults because these impacts “can be disguised as other age-related conditions that are common in older adults.”
This could include dementia, anxiety and depression.
And the number of patients in older age groups is not only increasing, researchers said, but is projected to continue increasing.
“In other words, there may be an aging population of people with substance use disorder,” said researchers.
At the same time, this risk of substance abuse among older adults in Hawaii and the motives behind it are “an issue that is underexplored in Hawaii,” they said.
The team calls for more engagement in the community, along with more research into why older adults continue using meth. They recommended prioritizing screening for substance use disorder among kupuna in Hawaii, along with targeted intervention and treatment options.
Older users might hesitate to seek treatment because they are less comfortable talking about their drug addictions than younger generations, according to Becker.
“There is often stigma and shame surrounding (substance use disorder), especially for kupuna, which can make it difficult for them to seek help,” Becker said. “Addressing these barriers could be key to reducing deaths in this vulnerable population.”
The study was published in the August issue of the Hawai‘i Journal of Health and Social Welfare.
