Being old means that you can deal with aches and pains. To treat pain, your doctor may prescribe a medicine. Opioid. You will join a large group of older adults: 9% of adults over the age of 65 and take an opioid for pain.

Opioids are one of the strongest types pain Reliever They can be very effective, especially for severe pain, says Carrie Reid, MD, PhD, an associate professor of medicine at Weil Cornell Medical College in New York and a pain management researcher.

But they also come with serious side effects, and older adults are at greater risk. If they are not taken as prescribed, opioids can cause a dependency or even Addiction. “As doctors, we’re constantly questioning if opioids do more good than harm,” Reid says.

Why so many older adults take Opioids

“By age, your body also does,” says Anesthesiologist Hanna M. Gazelka, MD, Chair of the Mayo Clinic Enterprise Opioid Stewardship Program in Rochester, MN. You are more likely to have a painful condition, such as Arthritis, Back injury, or Cancer.

If you need surgery for one of these problems, your doctor may prescribe an opioid to help you get better. “Severe is opioid drugs for the treatment of severe pain,” says Reid Gambhir. They were also given chronic pain, Usually as a last resort.

All of this explains why a person is 65 and older, who is three times more likely to take opioids than someone at the age of 20. About 20% of seniors fill a recipe for an opioid in a given year.

How Opioids Affect Older Adults Differently

Older adults often metabolize, or process, opioids differently. “When we age, we have more body fat,” Reid says. It increases the level of an opioid in the bloodstream. Your Kidney The drug cannot be filtered as efficiently so that it stays in your body for longer.

What’s more, opioids can interact with other medications that older people take, such as medications for sleep, Seizures, And nerve pain. “That’s why older adults are more likely to have side effects than those in their 20s or 30s,” says Reid. In one study, approximately 30% of men 65 and up responded by taking an opioid.

Common side effects include:


Risk of opioid misuse

Opioids increase brain A chemical called endorphin, which reduces pain and triggers feelings of pleasure. It is these fine sensations that can set the stage for abuse, misuse and addiction.

Missuse is when you use a drug in a way that your doctor did not intend, says Benjamin Han, an assistant professor of geriatrics, gerontology and assistant care at UC San Diego School of Medicine. For example, you take an extra dose for a sore throat. Or you pop a painkiller to relax and sleep is better.

Opioid abuse is a growing problem in older adults. One study found that 7% of adults up to the age of 50 admitted to abusing their prescription opioids. Reid can cause risk, Reid says. You can build a tolerance, where you need a higher dose of the drug to feel good.

Abuse opens the door for opioid use disorder. When opioids take a toll on your life. You cannot leave or cut back. Or your use affects your ability to work or care for your family. Other red flags include craving the drug or taking it in risky situations, such as when you are driving, Reid says.

Describing Opioids to Older Adults

Over the past two decades, a spike in opioid addictions and overdoses caused a public health crisis. Experts once thought that older adults were unlikely to abuse opioids, but found that it was not. Anyone of any age can depend on opioids, Ghazalka says.

As doctors and patients became more aware of these issues, prescriptions for opioids became nationwide. But they are still most common in older adults. Often, there are not many pain options in older patients, says Ghazalka. Or they may or may not know of other treatments, such as physical treatment, Acupuncture, And nerve blocks.

On the other hand, there is also concern that some doctors are very cautious about prescribing opioids. “There may be people who are not receiving these drugs, who can benefit from them,” says Reid. Or a person in severe pain may refuse an opioid because they are worried about intoxication.


How to safely take Opioids

If your doctor suggests an opioid, talk about the risks and side effects. It’s important that you start a conversation, Reid says. More than half of older adults with an opioid prescription say their doctor warned them about addiction or more than enoughAccording to a survey.

Ask these questions:

  • Do I have other options instead of opioid?
  • Have you written the lowest dose possible?
  • What side effects should I expect and how can I manage them?
  • How are we going to decide whether this medicine is working or not. Can we try something else if it doesn’t?
  • How often will you need to see me to keep track of your progress?
  • Will this opioid interact with any of my other medications?
  • Are you worried that I might get addicted?
  • How will taking this opioid affect my daily life, such as my driving?

While taking opioids, tell your doctor if there are any side effects or changes in your pain. You will also need follow-up appointments, where your doctor can ensure that the benefits of taking an opioid still outweigh the risks.



Benjamin Han, MD, assistant professor of geriatrics, gerontology, and palliative care, UC San Diego School of Medicine.
BMC Geriatrics: “Risk Factors of Opioid-Induced Adverse Reactions”
Clinical Intervention in Aging: “And Uses of the Elderly: Uses and Side Effects.”
Carrie Reid, MD, PhD, Associate Professor of Medicine, Weil Cornell Medical College in New York; Pain management researcher; Spokesman, American Geriatric Society.
CDC: “Opioid Basics: Commonly Used Terms,” ​​”Opioid Overdose: Understanding Epidoid.”
Helena M. Gazelka, MD, anesthesiologist; Chair, Mayo Clinic Enterprise Opioid Standardship Program in Rochester, MN.
Innovation in aging: “Rising Rates of Opioid Misuse among Older Adults in Emergency Departments.”
Mayo Clinic: “How Opioid Addiction Increases,” “Opioids and Other Drugs: What to Look For.”
Mayo Clinic Proceedings: “Opioids in Older Adults: Alternative Medicine for Indications, Prescription, Complications and First Aid.”
Michigan Opioid Prescription Engagement Network: “Older Addictive Experiences with Opioid Prescription: National Poll on Healthy Age.”
Morbidity and Mortality Weekly Report: “Diversity in Adult Outpatient Opioid Prescription Distribution by Age and Gender – United States, 2008–2018.”
National Institute on Drug Abuse: “Substance Abuse in Older Adults.”
preventive Medicine: “Prescription opioid misuse among middle-age and older adults in the United States, 2015–2016.”

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