Emergency room visits by seniors who have misused opioids more than tripled between 2006 and 2014, according to a new study.

The misuse of painkillers has had a snowball effect for seniors, leading to an increase in the number of chronic conditions, greater injury risk and higher rates of mental health diagnoses, researchers with Towson University found.

“Findings demonstrate the breadth and scope of opioid misuse and dependence among older adults visiting emergency departments — and indicate that targeted programs aimed at screening, intervention and treatment specifically geared toward older adults are warranted,” authors wrote in Innovation in Aging. “Results from this study also highlight the complexity of treating opioid dependence in this population, which reflect in part, high rates of coexisting mental health and other substance abuse disorders.”

Researchers studied multiple years of nationally representative data from the Nationwide Emergency Department Sample. That included more than 950 hospitals, across 34 states and the District of Columbia. Visit rates by adults older than 65 for opioid misuse increased 217% during the study period.