Long-Term Opioid Prescriptions Decline in U.S. While Safety Risks Surge for Aging Patient Population

JAMA study shows long-term opioid prescriptions declined through 2023, but aging patients on Medicare face new dangers from risky drug combinations.

By: AXL Media

Published: Apr 8, 2026, 11:37 AM EDT

Source: Information for this report was sourced from EurekAlert!

Progress in National Opioid Stewardship Efforts

Data released in April 2026 highlights a definitive downward trend in the number of Americans receiving long-term opioid therapy over the last eight years. Researchers attribute this decline to successful national opioid stewardship programs and a heightened public and clinical awareness of the risks associated with chronic opioid use. Despite this progress, the volume of patients remains substantial. Depending on the clinical definition applied, between 4 million and 5 million patients were still being prescribed long-term opioid therapy in 2023, indicating that while the trajectory is positive, the reliance on these medications for chronic pain management persists for millions.

Demographic Shifts Toward an Aging Electorate

The study identified a significant shift in the demographics of those receiving long-term prescriptions. Between 2015 and 2023, the average age of the patient population receiving these medications increased. Data shows that the largest proportion of long-term opioid therapy is now covered by Medicare, signaling that the burden of chronic pain and its pharmacological management has moved decisively into the older adult population. This transition presents new challenges for the healthcare system as it adapts to managing opioid use in patients who are often dealing with multiple concurrent health conditions.

Escalating Risks of Polypharmacy and Adverse Events

With the aging of the patient pool, concerns regarding polypharmacy—the simultaneous use of multiple drugs—have moved to the forefront of clinical safety discussions. Older adults are physiologically more susceptible to adverse events from complex medication regimens. The researchers expressed specific alarm over the increased rates of coprescribing opioids with other substances, particularly gabapentinoids. This combination can significantly depress the central nervous system, increasing the likelihood of respiratory distress, falls, and other life-threatening complications in an already vulnerable demographic.