Seniors Are at Special Risk with Opioid Medications

Many of us, when thinking about the risks of drug addiction, are mostly concerned about teens and youth rather than peers or our elders.  It is true that we have been experiencing a surge of heroin addiction in this country and that the average age of heroin abusers has typically been around 23.  However, prescription medications are another story.  Despite the fact that opioid medications were designed for short-term pain, they have been prescribed for many chronic conditions that afflict older Americans disproportionately.  Over time, a tolerance occurs, and more medication is required to combat the pain.  Older adults increased their E.R. visits by 78% from 2006 to 2012 due to drug misuse.  Nearly half of those visits were by people age 75 and older, while 53 percent were between the ages of 65 and 74.

Opioid medications are more addictive than previously thought—you can become physically dependent in as few as five days.  At that point, the pain that the opioid seems to help relieve may actually be withdrawal pain.  Older adults are less able to handle the effects of opioid medications physiologically.  Medicines accumulate more easily in a body where all the systems are slowing down due to age.  Senior citizens are often on several medications that can, and often do, interact with each other.  Any use of alcohol intensifies the effects of opioids. 

Opioid-related side effects are many, and might be missed by doctors and caregivers.  Possible red flags might include anxiety and depression, confusion and disorientation, and injuries.  Side effects can include falls, dizziness, headaches, sedation, severe constipation, and slow reaction times.  Elderly adults taking opioid painkillers have 4 times as many bone fractures, are 68% more likely to be hospitalized and are 87% more likely to die as those taking over the counter medication.

It is important to consider the risks before taking, or allowing loved ones to take, opioids.  While they may ease suffering at the end of life, or be useful for a short time following surgery, consider refusing them if they are recommended for any chronic pain.  A multifaceted approach to pain management, including cognitive-behavioral therapy and activity coaching, has been proven to be very successful.