As Overdose Deaths Among Seniors Rise, a Fentanyl Vaccine Offers Hope
by Don Drake, Connelly Law Offices, Ltd. 9.4.24
The 2018 National Survey on Drug Use and Health found that almost one million adults aged sixty-five or older, accounting for 2% of all seniors, reported a substance use disorder in the past year. The survey also revealed that alcohol and prescription opioids are the most abused substances among seniors.
"Elderly individuals are at heightened risk of prescription drug misuse and addiction, as many of them are prescribed multiple medications at the same time," stated professional fiduciary and certified elder law Attorney RJ Conelly III. "It has been observed that as many as 11% of the elderly demographic may be affected by the misuse of prescription drugs. Alarmingly, the misuse of opioids poses a significant risk, with a noticeable increase in fatal opioid overdoses among seniors over the past decade. Some individuals from the baby boomer generation also carry a history of illicit drug usage into their later years, further complicating this issue. As a result, our firm has experienced a notable upsurge in requests to be representative payees to assist older adults and seniors grappling with substance abuse challenges."
As Attorney Connelly indicated, the opioid crisis has had a considerable impact on the baby boomer generation (born between 1947 and 1964), with a substantial rise in mortality rates from prescription opioid overdose since 2010.
"Opioid and other substance abuse are prevalent among older adults, yet they are often overlooked and insufficiently addressed," Attorney Connelly continued. "Studies predict that the number of older adults with substance use disorders is expected to increase substantially as the population ages. Unfortunately, age-specific services are limited, and challenges such as social isolation, financial constraints, physical disabilities, and lack of transportation can hinder access to suitable programs for this age group."
Fentanyl and Seniors
Elderly individuals are frequently prescribed opioids such as fentanyl to manage chronic pain. Fentanyl, available in patch form under the brand name Duragesic, is highly addictive and can be misused, posing a risk to those with or without a prescription. Seniors may be particularly vulnerable to substance abuse due to various age-related issues, and their addiction problems often go unnoticed.
According to the CDC, there has been a 53 percent increase in overdose death rates related to synthetic opioids like fentanyl among older Americans. Fentanyl is especially perilous as it is often mixed with street drugs such as cocaine, methamphetamine, and other prescription opioids, as well as counterfeit benzodiazepines like Xanax.
The FDA approved this potent synthetic opioid for pain relief and anesthesia. It is estimated to be around one hundred times more potent than morphine and fifty times more potent than heroin in its pain-relieving effects. Similar to other opioid analgesics, fentanyl can produce various effects, including relaxation, euphoria, pain relief, sedation, confusion, drowsiness, dizziness, nausea and vomiting, urinary retention, pupillary constriction, and respiratory depression.
A Vaccine Goes to Trial
University of Houston researchers have achieved a breakthrough in creating a vaccine that can block the effects of fentanyl by preventing it from reaching the brain. The vaccine, detailed in the journal Pharmaceutics, has the potential to address the nation's opioid epidemic by helping individuals avoid relapse. Opioid Use Disorder (OUD) is treatable, but the high relapse rate is a significant challenge.
The significance of this research is underscored by the alarming rates of overdose deaths involving synthetic opioids like fentanyl. Even a small amount of fentanyl can be lethal. Lead author Colin Haile, a research associate professor of psychology at UH, has expressed confidence in the potential impact of their findings. The vaccine triggers anti-fentanyl antibodies that bind to fentanyl, preventing its entry into the brain and leading to its elimination from the body. This effectively prevents its euphoric effects and can support individuals in pursuing sobriety.
Creating a vaccine against fentanyl has been a challenge since the 1970s due to opioids not being readily recognized as invaders by our immune systems. However, the researchers have utilized a potential approach by attaching a part of the drug to a harmless part of a bacteria that triggers an immune response.
The researchers have attached part of fentanyl to an enterotoxin, a harmless chemical made by the bacteria E. coli. This has been tested in fifteen human trials with minimal side effects. It has also shown effectiveness in trials in rats and is ready to enter the Phase I trial.
The anti-fentanyl antibodies triggered by the vaccine are specific to fentanyl and its derivatives and do not affect other opioids like morphine. This means that vaccinated individuals would still be able to receive pain relief treatment with other opioids.
A Final Word
"There has been a concerning increase in the misuse and abuse of alcohol, opioids, heroin, prescription medications, and marijuana among middle-aged and older adults, commonly referred to as the invisible epidemic," said Attorney Connelly. "As stated earlier, the CDC has reported a 53% rise in overdose death rates associated with synthetic opioids in older Americans. On a positive note, clinical trials for fentanyl and opioid vaccines have commenced, offering hope for saving lives. Despite this progress, there is still a pressing need to develop specialized treatment programs tailored to this specific age group. While the introduction of vaccines marks significant progress, there is no denying that substantial work lies ahead in addressing substance abuse issues among older adults and seniors."
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