feel like I work at the morgue sometimes.”
Larnell Robinson, tenant council president of a West Baltimore high-rise for low-income seniors, marks off names on a list—a sad tally of residents lost to overdoses on fentanyl and other drugs.
In recent years, he has seen 15 such deaths.
William, 63, was found in his ninth-floor apartment, dead from fentanyl. Richard, 61, overdosed soon after. Three days later, David, 68, was also found dead—another victim of fentanyl.
First came prescription opioids. Then heroin. Then fentanyl. Now, the fourth wave of the epidemic has arrived—a deadly fusion of fentanyl with stimulants like cocaine and methamphetamine.
This latest surge has been years in the making, but the myth that addiction targets only the young has masked its growing toll among older Americans.
Overdose deaths among seniors from fentanyl mixed with stimulants have skyrocketed.
That myth was thoroughly debunked at the annual meeting of the American Society of Anesthesiologists in San Antonio, where researchers presented a study based on statistical evidence from the Centers for Disease Control and Prevention (CDC).
Factually, over the past eight years, overdose deaths among seniors from fentanyl mixed with stimulants have skyrocketed by an astounding 9,000 percent—underscoring that older Americans, who often already take multiple medications for chronic conditions, are especially vulnerable to overdose. With a bathroom cabinet full of prescription drugs and a slower metabolism that prolongs their effects, combining opioids with meth or cocaine becomes a lethal gamble.
It’s a crisis few saw coming. “Our analysis shows that older adults are also impacted by fentanyl-related deaths and that stimulant involvement has become much more common in this group,” said Gab Pasia, lead author of the study and a University of Nevada, Reno School of Medicine student.
Between 1999 and 2023, fentanyl claimed the lives of more than 17,000 senior citizens. The most alarming surge came after 2015, when stimulants began appearing alongside fentanyl. Since 2020, deaths among seniors involving both fentanyl and stimulants have soared, even as fatalities from other substances have leveled off.
Fentanyl alone is dangerous enough. Just the equivalent of a few grains of salt can kill you.
Dr. Larissa K. Laskowski, a medical toxicologist at NYU Langone Health, said that the study’s findings are “not surprising,” since illicit fentanyl is “one of the deadliest substances known to man.”
“In recent years, it has proliferated throughout the illegal drug market,” she added. “Fentanyl is regularly found in supplies of cocaine and methamphetamine.… There is no quality control. Many drugs today are laced with fentanyl.”
In response, alarmed experts are urging clinicians to take immediate action—educating older patients and their caregivers about the dangers and warning signs of overdose, exercising greater vigilance in prescribing opioids, and exploring safer, non-opioid options for managing pain.
But reversing course will require more than clinical caution—it demands public awareness and accountability. Communities, families and policymakers must confront the realities of an evolving crisis, and dispel the myths that have allowed it to spread unchecked. Only then can prevention and treatment efforts gain real traction.
If we act quickly, the fourth wave won’t be the one that buries as many of our elders as it already has our youth.
