UH study: Meth poisoning leading cause for fatal overdoses in older Hawaiʻi residents

A new study by researchers at the University of Hawaiʻi at Mānoa’s Center on Aging finds that methamphetamine poisoning is the leading cause of fatal overdoses among midlife and older adults in Hawai‘i. The research was published in the August 2024 issue of Hawaiʻi Journal of Health and Social Welfare.

Between July 2020 and December 2021, 263 drug-related deaths were recorded across the state. Of these, more than half (58.2%) involved individuals between the ages of 50 and 79, with methamphetamine toxicity accounting for 64.3% of those deaths—compared to just 16.4% from opioid poisoning.

The study, conducted by Gursimran K. Sidhu, Tiana M. Fontanilla and Treena S. Becker, found that older adults were more likely to die from methamphetamine poisoning than their younger counterparts, while younger people were more vulnerable to opioid-related deaths. The researchers utilized data from the State Unintentional Drug Overdose Reporting System, a CDC-funded initiative, to analyze these overdose patterns.

In addition to reviewing medical examiner reports, toxicology reports and death investigator narratives, the team also found that many older decedents had a history of cardiovascular disease—a condition that can increase the risk of fatal outcomes in methamphetamine users.

“People who use drugs long-term in Hawai‘i tend to favor methamphetamine, and this trend becomes more lethal as they age,” said Becker. 

According to the researchers, many people in midlife and older ages have been using methamphetamine for decades. This chronic drug use, coupled with age-related health issues, makes older adults particularly vulnerable to methamphetamine poisoning. The report suggests that older users often face different risks and barriers to treatment than younger users, including higher levels of stigma.

The team called for more research into why older adults continue using methamphetamine, noting that “motives for use in older age are largely unexplored.”

Researchers recommend prioritizing screening for substance use disorder among older adults in Hawai‘i and offering tailored treatment. 

“There is often stigma and shame surrounding SUD, especially for kūpuna (older adults), which can make it difficult for them to seek help,” Becker said. “Addressing these barriers could be key to reducing deaths in this vulnerable population.”

The Center on Aging is housed in the Thompson School of Social Work & Public Health.