Data Sheet 1_The intersection of aging, pain, and opioid use disorder: a retrospective chart review from an outpatient opioid treatment clinic.pdf

IntroductionOlder adults represent a growing proportion of individuals with opioid use disorder (OUD) and adults 55 + are significantly more likely to experience a fatal overdose. This exploratory pilot study examined age-related differences in health and treatment characteristics among patients in outpatient opioid treatment to assess whether older adults show distinct patterns compared to younger patients, providing insight into this growing population.
MethodsThis retrospective chart review analyzed data from 79 patients (ages 23–70) seeking care at a low-threshold outpatient opioid treatment clinic. Data were extracted from electronic health records and included demographics, substance use, diagnoses, current pain, depression, quality of life, and treatment characteristics. Associations between age and clinical variables were analyzed using correlational, logistic regression, and repeated-measures ANCOVA methods.
ResultsOlder age was predictive of past pain-related diagnoses and older adults (55+) longer histories of illicit opioid use (mean = 30 years) and tobacco smoking (mean = 43 years) compared to younger adults. While polysubstance use was more common among younger patients, fentanyl use was high across all ages (∼65%). Older adults received higher methadone doses and remained in treatment longer. Despite greater chronic exposure to opioids, age was not significantly associated with depression or quality of life scores at intake.
ConclusionsFindings from this pilot study reveal age-related patterns in substance use, pain history, and treatment engagement among patients with OUD. The data suggest that older adults may face unique risks related to cumulative opioid exposure, while also demonstrating potential protective factors such as treatment retention. Integrated, age-responsive approaches are urgently needed to address the complex needs of this growing population.

引言：老年群体在阿片类使用障碍（opioid use disorder, OUD）患者中的占比持续攀升，且55岁及以上人群发生致命过量用药的风险显著更高。本探索性预试验针对门诊阿片类治疗患者的健康与治疗特征的年龄差异展开研究，旨在评估老年患者与年轻患者是否存在显著不同的临床特征模式，为深入了解这一不断增长的患者群体提供参考。
研究方法：本回顾性病历回顾研究分析了79名年龄介于23至70岁之间、于低门槛门诊阿片类治疗诊所就诊的患者数据。研究数据提取自电子健康档案，涵盖人口统计学特征、物质使用情况、诊断结果、当前疼痛状况、抑郁症状、生活质量及治疗特征等内容。采用相关分析、逻辑回归（logistic regression）及重复测量协方差分析（repeated-measures ANCOVA）方法，对年龄与临床变量之间的关联进行分析。
研究结果：高龄与既往疼痛相关诊断呈显著正相关；与年轻成人相比，老年患者（55岁及以上）的非法阿片类药物使用史（平均时长30年）与烟草吸烟史（平均时长43年）更长。尽管多物质使用在年轻患者中更为普遍，但所有年龄段的患者芬太尼使用比例均较高（约65%）。老年患者接受的美沙酮剂量更高，且治疗留存时间更长。尽管长期暴露于阿片类药物的程度更高，但入组评估时的抑郁症状评分与生活质量评分并未与年龄呈现显著关联。
结论：本预试验的研究结果揭示了阿片类使用障碍患者在物质使用、疼痛史及治疗参与度方面的年龄相关特征模式。数据表明，老年患者可能面临与累积阿片类药物暴露相关的独特风险，同时也展现出治疗留存等潜在保护因素。亟需整合的、适配年龄特征的干预方案，以满足这一不断增长的群体的复杂医疗需求。