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A client draws up fentanyl in the consumption room at Moss Park Consumption and Treatment Service in Toronto, in 2024. The number of older Canadians living with opioid use disorder has more than doubled since 207, according to a new report.Chris Young/The Canadian Press
The number of older Ontarians living with opioid use disorder (OUD) has more than doubled over the past decade, according to new research that highlights how the country is not currently equipped to support this growing population.
The Ontario Drug Policy Research Network, in a report released on Wednesday, said there were 15,231 Ontarians aged 55 and older with OUD by the end of last year, up from 7,116 in 2017. This amounts to roughly one in every 350 older adults in the province.
Additionally, the study highlighted that the rate of older adults on opioid agonist therapy, which involves the use of medications to treat opioid addiction, has more than tripled since 2013. The proportion of deaths in this age group involving fentanyl also spiked, reflecting the growing reach of the illicit drug market.
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Epidemiologist Tara Gomes, the principal investigator of the ODPRN, said this population, which faces distinct risks compared with younger people, has not been studied enough. But it should be a focus in the drug toxicity crisis as Canada’s population ages, she added.
“We are likely going to see more and more people with complex needs around drug use and who need specific supports in our health care system that we may not be ready for if we don’t start paying attention now,” said Dr. Gomes.
Conversations on the opioid crisis have largely focused on younger age groups, specifically men between the age of 30 and 39 who are dying in the greatest numbers. But Dr. Gomes said the drug-using population is aging, specifically those who were first exposed to prescription opioids in the 1990s and 2000s and have transitioned to the illicit market.
Substance use is associated with accelerated aging and earlier onset of age-related disease and morbidity, according to the study, which can lead to increased clinical complexity and health care needs. There are also social factors to consider, such as loneliness, isolation and lacking supports.
The authors of the report concluded that there is a “pressing need” for Ontario’s health care and social service systems, including institutional settings such as long-term care, to improve their substance-use supports for older people.
The ODPRN said there is “an urgent need to proactively adapt care delivery, resourcing, and training to ensure high-quality care for people who use substances as they age.”
Data used in the report came from ICES, a non-profit Ontario research institute, covering the period between January, 2013, and December, 2025.
The ODPRN chose to look at adults aged 55 and older, instead of the seniors’ benchmark of 65, because people who use drugs in that age group often have chronic health conditions and medical complexities that mirror the profile of someone much older.
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Dr. Gomes said long-term care is a setting that needs significant attention, pointing to data included in the report that showed the rate of admissions for people with OUD has not changed since 2017 despite there being a growing population. She said some older people can find long-term care spaces that help manage their substance use but said “that’s the exception, not the norm.”
Many pharmacies and long-term care homes will not dispense opioid agonist treatments, such as methadone and buprenorphine, adding barriers for the older drug-using population.
These settings must “have the policies and skills and infrastructure in place to offer beds to people with opioid use disorder,” said Dr. Gomes. She added that new models for supportive housing that can serve this population are needed.
Improvements can also be made in the screening and diagnosis of OUD in the older population and improving access to harm-reduction services, such as drug checking, and existing treatments, according to the report.
Accessibility, too, is an obstacle to care, specifically for adults with disabilities, mobility issues, transportation limitations and those in congregate settings.
Dr. Gomes said the report is a “first step” to increase awareness and push the conversation forward on how to best serve this population and prevent deaths.