elder abuse, opioid crisis, Adult Protective Services
As the opioid crisis has deepened over the past twenty years, its effect on individuals and families, including older adults, has grown. To find out how the opioid crisis might be impacting elder abuse, neglect, and exploitation in Maine, we conducted a mixed methods analysis of 2015-2018 Maine Adult Protective Services (APS) investigations to determine: 1) Did opioid-related investigations increase over time? 2) Do investigations involving opioid misuse or abuse differ from investigations that don’t involve opioids? 3) What themes or features of cases involving opioid misuse or abuse by clients and/or perpetrators emerge from the data?
Key Findings: The annual number of opioid-related investigations increased 2015-2018, but the rate of increase was parallel to the general increase of elder abuse investigations over the time period. Opioid-related investigations ranged between 2.5-2.9% of all elder abuse investigations over the time period. Clients in opioid-related investigations tended to be younger than clients in non-drug-related investigations. Forty percent of clients in Opioid-related investigations were 60-69 years old compared to twenty-three percent of clients in Non-drug-related investigations. Opioid-related investigations were more likely to have three or more allegations and include an allegation of exploitation compared to Non-drug-related investigations.
Common themes in the opioid-related investigations included: Clients with opioid prescriptions also exhibited signs of substance use disorder (SUD) or opioid use disorder (OUD); clients with opioid prescriptions had difficulties managing their prescriptions, including taking too much or too little, or needing to hide their medication to keep them away from family members or others.; clients with opioid prescriptions encountered barriers to obtaining the medications such as not being able to have their pharmacy deliver them, having to travel to appointments for pill counts, or being denied access to an opioid medication due to the behavior of a family member. In exploitation investigations, there were instances of the perpetrator stealing the client's money or property to purchase drugs elsewhere as well as instances of stealing the client's money and the client's opioid prescription. Client use of opioids can put them at risk of exploitation through impaired physical and cognitive ability.
This report was prepared under a contract between the Muskie School of Public Service, University of Southern Maine and the Maine Department of Health and Human Services (DHHS), Office of Behavioral Health (formerly Substance Abuse and Mental Health Services), DHHS Agreement #OSA-20-903 and supported through the following federal grants: Centers for Disease Control and Prevention (CDC) #1 NU17CE924969-01 Injury Prevention and Control Research and State and Community Based Programs; Substance Abuse & Mental Health Services Administration (SAMHSA) #1 NU17CE924969-02 Injury Prevention and Control Research and State and Community Based Programs; and CDC #1 NU90TP921964-01-00 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response.
Snow, Kimberly I., Pratt, J.L., Bratesman, S. (2020). The Role of the Opioid Crisis in Elder Abuse: An Analysis of Maine Adult Protective Services investigations, 2015-2018. Portland, ME: University of Southern Maine, Muskie School of Public Service, Cutler Institute.