{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T11:22:09Z","timestamp":1778757729983,"version":"3.51.4"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T00:00:00Z","timestamp":1741651200000},"content-version":"vor","delay-in-days":69,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Objectives<\/jats:title>\n                  <jats:p>The opioid crisis has run rampant throughout America, with communities in rural Appalachia especially hard hit. While the direct effects of opioid use disorder on individuals, families, and communities are well documented, an unforeseen consequence of this crisis is the abuse of older adults by family members or paid caregivers with opioid addiction. The purpose of this study was to characterize cases of opioid-involved elder abuse compared to cases where opioids were not involved.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Research Design and Methods<\/jats:title>\n                  <jats:p>Guided by lifecourse and ecological perspectives, we analyzed quantitative case data and narrative notes for 220 substantiated incidences of abuse of persons aged 60+ that occurred between 2015 and 2017 in eastern Kentucky. Multinomial logistic regression analysis with robust standard errors was used to compare cases on key variables including the older adults\u2019 age, gender, income, activities of daily livings\/instrumental activities of daily livings, and cognitive capacity. Composite narratives developed from thematic analysis of the case notes were used to contextualize opioid-involved elder abuse cases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We found 25 opioid-involved cases of elder abuse and 15 cases in which the perpetrator used alcohol\/other drugs. Compared to cases not involving substance abuse, women were more frequently victims of perpetrators who use opioids and alcohol\/other drugs. Victims of opioid-involved abuse were more likely to experience material exploitation (stealing medication) than when perpetrators misused alcohol\/other drugs or used no substances. A primary pathway to elder abuse was older adults taking in a family member due to various life circumstances. A second pathway to opioid-involved abuse was when older adults relied on the perpetrator for support and assistance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion and Implications<\/jats:title>\n                  <jats:p>Opioid misuse by perpetrators heightened susceptibility to elder abuse. Older adults are often protective of their struggling families and may not recognize their own vulnerabilities. Interventions sensitive to cultural norms and close family relationships are needed to combat opioid-involved elder abuse.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/geroni\/igaf029","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T04:17:24Z","timestamp":1741666644000},"source":"Crossref","is-referenced-by-count":3,"title":["Family Ties and Opioid Lies: Pathways to Elder Abuse in Rural Appalachia"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1153-1811","authenticated-orcid":false,"given":"Karen A","family":"Roberto","sequence":"first","affiliation":[{"name":"Center for Gerontology, Virginia Tech , Blacksburg, Virginia ,","place":["USA"]},{"name":"Institute for Society, Culture and Environment, Virginia Tech , Blacksburg, Virginia ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7142-3770","authenticated-orcid":false,"given":"Jyoti","family":"Savla","sequence":"additional","affiliation":[{"name":"Center for Gerontology, Virginia Tech , Blacksburg, Virginia ,","place":["USA"]},{"name":"Department of Human Development and Family Science, Virginia Tech , Blacksburg, Virginia ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9519-1967","authenticated-orcid":false,"given":"Pamela B","family":"Teaster","sequence":"additional","affiliation":[{"name":"Center for Gerontology, Virginia Tech , Blacksburg, Virginia ,","place":["USA"]},{"name":"Department of Human Development and Family Science, Virginia Tech , Blacksburg, Virginia ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6210-5332","authenticated-orcid":false,"given":"Brandy Renee","family":"McCann","sequence":"additional","affiliation":[{"name":"Center for Gerontology, Virginia Tech , Blacksburg, Virginia ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,3,11]]},"reference":[{"issue":"2","key":"2025062507121366200_CIT0001","doi-asserted-by":"crossref","first-page":"292","DOI":"10.2105\/AJPH.2009.163089","article-title":"Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential","volume":"100","author":"Acierno","year":"2010","journal-title":"American Journal of Public Health"},{"key":"2025062507121366200_CIT0002","author":"Administration for Community Living","year":"2019"},{"key":"2025062507121366200_CIT0003","author":"Appalachian Regional Commission (ARC)","year":"2019"},{"issue":"6","key":"2025062507121366200_CIT0004","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1037\/\/0012-1649.22.6.723","article-title":"Ecology of the family as a context for human development: Research perspectives","volume":"22","author":"Bronfenbrenner","year":"1986","journal-title":"Developmental Psychology"},{"key":"2025062507121366200_CIT0005","volume-title":"Rural people and communities in the 21st century: Resilience and transformation (2nd ed.)","author":"Brown","year":"2019"},{"issue":"2","key":"2025062507121366200_CIT0006","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1177\/0886260516640782","article-title":"Examining the role of substance abuse in elder mistreatment: Results from mistreatment investigations","volume":"34","author":"Conrad","year":"2019","journal-title":"Journal of Interpersonal Violence"},{"issue":"4","key":"2025062507121366200_CIT0007","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1300\/j135v07n04_06","article-title":"Self-reported elder domestic partner violence in one rural Iowa county","volume":"7","author":"Daly","year":"2008","journal-title":"Journal of Emotional Abuse"},{"issue":"5","key":"2025062507121366200_CIT0008","doi-asserted-by":"publisher","first-page":"e49","DOI":"10.1093\/geronb\/gbx023","article-title":"Using latent class analysis to identify profiles of elder abuse perpetrators","volume":"73","author":"DeLiema","year":"2018","journal-title":"The Journals of Gerontology. 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