Elderly Patients

Buprenorphine is FDA-approved for use among elderly patients.

Follow these guidelines when treating elderly patients with buprenorphine:

  • Addiction is often difficult to diagnose in the elderly since it mimics many problems that occur during the aging process. Look for prescription opioid misuse in this population when making a diagnosis.
  • Be aware that elderly people often have different rates of metabolism and absorption, and differences in body composition compared to younger patients, all of which may impact buprenorphine dosing.
  • Be aware of possible drug-drug and drug-disease interactions, especially during induction. Benzodiazapine use is common among the elderly (Blow, 2003; SAMHSA, 1998).
  • Elderly patients need lower doses of many medications, and in general they should be started at a lower dose of buprenorphine and titrated at a slower rate. Their buprenorphine maintenance dose will generally be lower than the standard as well.
  • Elderly opioid-dependent patients with high relapse or withdrawal potential or patients with severe comorbidities may need to be hospitalized during induction.
View ReferencesHide References
Blow FC. Special issues in treatment: old adults. In: Graham AW, Schultz TK, May-Smith MF, Ries RK, Wilford BB, eds. Principles of Addiction Medicine, 3rd ed. Chevy Chase, Md: American Society of Addiction Medicine. 2003.
Substance Abuse and Mental Health Services Administration. Substance Abuse Among Older Adults. Treatment Improvement Protocol Series, No. 26. Rockville, Md: Center For Substance Abuse Treatment. USDHHS Publication (SMA) 98-3179. 1998.


Related Resources: 
TIP 26: Substance Abuse Among Older Adults
Description: 
Guideline document designed to aid treatment providers deliver better services to elderly patients with substance use disorders.
Source: 
Substance Abuse and Mental Health Services Administration (SAMHSA)
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Psychoactive drug use in older adults
Description: 
This article discusses the abuse and misuse of psychoactive drugs among adults over the age of 50.
Source: 
American Journal of Geriatric Pharmacotherapy
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Computerized screening of substance abuse problems in a primary care setting: older vs. younger adults
Description: 
This study examined the responses of older adults to the Drug Abuse Problem Assessment for Primary Care (DAPA-PC), a computerized drug and alcohol abuse screening instrument developed for primary care settings.
Source: 
American Journal of Drug and Alcohol Abuse
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