For all the attention on young people caught in the grip of the nation's opioid addiction epidemic, the spotlight has missed the growing population of older Americans quietly living, and increasingly dying, as addicts.

The phenomenon is becoming increasingly clear in Maryland as the deaths of older addicts continues to spike.


Middle-aged Marylanders — those from 45 to 54 — have been dying of overdoses at the highest rates, according to the state Department of Health and Mental Hygiene.

Potentially poised to overtake this group are those age 55 and older. This group had one of the biggest jumps in overdose deaths over the last eight years, with fatalities up 130 percent to 241 people.

David Semanco, clinical director at Serenity Acres Treatment Center, said older people have more pain, and are much more likely to have been prescribed powerful opioid-based painkillers. These have been shown to lead to addiction in some people.

"It starts with knee pain or a hip replacement or back problems, and a lot of time this is their first exposure to an opioid," Semanco said. "In many cases, the risk of using these drugs greatly exceeds the benefit. ... But it's our mindset now. We've been conditioned to seek immediate relief so we're not experiencing any pain whatsoever."

Once they run out of refills at the pharmacy, and amid a recent crackdown by law enforcement in getting pain pills on the street, sometimes these people move onto illicit drugs such as heroin or fentanyl.

State health officials say those street drugs — and particularly the extra-potent fentanyl, which is often mixed with heroin, unknown to users — are fueling the spikes in overdose deaths.

All age groups have seen large increases in deaths, which are up 81 percent statewide from 2008 to 2015, when there were 1,259. Those ages 25 to 34 did have the biggest jump in deaths over that time; their overdose fatalities were up 165 percent to 297.

Deaths among those ages 45 to 54 were up 53 percent to 339 in 2015. Among those younger than age 25 the increase was 52 percent to 99. Among those aged 35-44, the increase was 47 percent to 281.

The U.S. Centers for Disease Control and Prevention released guidelines in March on prescribing opioids for pain management.

The state Department of Health and Mental Hygiene has trained physicians on prescribing opioids, and created a prescription drug monitoring program that allows doctors and pharmacies to track them in an electronic database. The state also operates a hotline at 800-422-0009 that people with addictions can call for treatment.