Hidden Risks in the Medicine Cabinet: Opioids and Older Adult Safety

Older adults are more sensitive to such medicines, making careful use, monitoring and caregiver involvement critical to preventing serious harm, warn Poison Control experts

The New Jersey Poison Control Center is urging older adults and their caregivers to take extra precautions with opioid medicines. While opioids are commonly prescribed for pain management, older adults are especially vulnerable to accidental misuse, drug interactions and life-threatening side effects.

"Age-related changes in the body make older adults more sensitive to opioids," said Diane Calello, executive and medical director of the New Jersey Poison Control Center at Rutgers New Jersey Medical School. "Even when taken as prescribed, opioids can cause confusion, drowsiness, dangerous falls, slowed breathing and overdose."

Opioid poisoning among older adults (ages 55 and older) remains a serious concern for the New Jersey Poison Control Center, as the risk for dangerous health effects increases with age. In 2025, the poison control center responded to 334 opioid-related exposure cases, an increase from 321 cases in 2024.

These exposures frequently involved patients who accidentally took too much of a prescription opioid, combined opioids with alcohol or other sedating medicines, misused prescription opioids or used illicit substances, many of which resulted in hospitalizations and serious, sometimes life-threatening complications.

Key Risks for Older Adults on Opioids:

• Greater sensitivity to medication side effects due to age-related changes in metabolism
• Higher likelihood of dangerous drug interactions (especially with sleep aids, antianxiety medicines and alcohol)
• Memory or vision issues increasing the chance of taking the wrong dose
• Increased risk of falls, fractures and overdose

Safety Tips for Older Adults and Caregivers:

• Use a pill organizer to help prevent dosing errors and keep an up-to-date list of all medicines. Choose a child-resistant organizer if children live in or visit the home.
• Never mix opioids with alcohol or sedating medications unless cleared by a doctor.
• Store medicines in a secure location away from children, visitors and pets.
• Dispose of unused opioids at community take-back locations.
• Call the New Jersey Poison Control Center at 1-800-222-1222 immediately if you're unsure about a dose or if symptoms occur.

"Families can play a big role in helping older adults stay safe," Calello said. "Something as simple as setting up a daily pillbox or checking in on medication routines can prevent an overdose."

Children, teenagers and adults may get help 24/7 by calling the Poison Helpline at 1-800-222-1222 or chatting here. If someone isn't breathing, is having difficulty waking up or having a seizure, call 9-1-1.