• Benjamin H Han, Mirella A Orozco, Mari Miyoshi, Heidi Doland, Alison A Moore, and Katie Fitzgerald Jones.
• Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, University of California San Diego, La Jolla, CA, USA. b2han@health.ucsd.edu.
• J Gen Intern Med. 2024 Jul 1; 39 (9): 167316801673-1680.

BackgroundThe number of older adults entering opioid treatment programs (OTPs) to treat opioid use disorder (OUD) is increasing. However, the lived experiences of aging in OTPs have not been examined.ObjectiveTo explore the aging experience with OUD and barriers to medical care for older adults who receive care in OTPs.DesignFrom November 2021 to July 2022, we conducted 1-to-1, semi-structured qualitative interviews in English and Spanish, audio-recorded, transcribed, systematically coded, and analyzed to identify key themes regarding the challenges of aging with OUD and managing chronic diseases.ParticipantsThirty-six adults aged ≥ 55 enrolled in OTPs in San Diego, California.ApproachA descriptive qualitative approach was used. Major themes and subthemes were identified through thematic analysis until thematic saturation was reached.Key ResultsAll participants were on methadone and had a mean age of 63.4 (SD 5.1) years; 11 (30.6%) identified as female, 14 (39%) as Hispanic/Latino, and 11 (36%) as Black, with a mean duration of methadone treatment of 5.6 years. Chronic diseases were common, with 21 (58.3%) reporting hypertension, 9 (25%) reporting untreated hepatitis C, and 32 (88.9%) having ≥ 2 chronic diseases. Three major themes emerged: (1) avoidance of medical care due to multiple intersectional stigmas, including those related to drug use, substance use disorder (SUD) treatment, ageism, and housing insecurity; (2) increasing isolation with aging and loss of family and peer groups; (3) the urgent need for integrating medical and aging-focused care with OUD treatment in the setting of increasing health and functional challenges.ConclusionsOlder adults with OUD reported increasing social isolation and declining health while experiencing multilevel stigma and discrimination. The US healthcare system must transform to deliver age-friendly care that integrates evidence-based geriatric models of care incorporated with substance use disorder treatment and addresses the intersectional stigma this population has experienced in healthcare settings.© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.

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