The nationwide opioid crisis may cause a rise in elder abuse in rural areas, according to a report published Thursday by Grantmakers in Aging.

While seniors suffering from chronic pain may experience opioid addictions of their own, the issue can also cause “aftershocks” that “stretch far beyond the harm to addicted individuals,” the report found.

“In tight-knit rural communities, older people are often drawn into the struggles of addicted children, friends, and extended family, which can turn their own lives upside down,” the authors wrote.

Adult children with opioid addictions may move back in with their elderly parents, making them “easy targets” for financial, physical and emotional abuse. The GIA paper cites a report from the Boston Globe that found a recent 37% increase in elder abuse cases was likely tied to the opioid crisis.

The paper offers a policy “prescription” to expand and improve services that prevent, detect and fight elder abuse and financial exploitation such as ombudsman programs and healthcare provider training.

Medicare and Medicaid also play a role in the opioid crisis, the report showed. Seniors in rural areas are more likely to be dual eligibles and at a higher risk for opioid misuse. Currently 1.2 million Medicaid beneficiaries receive coverage for opioid abuse treatments.

“The stakes are high, and the question of how efforts to change or cut the program would alter coverage and health outcomes remains a topic of vehement debate,” the authors wrote.