Opioids, a class of prescription pain relievers, have increased in prevalence in the last decade, with an estimated
Yet these common medications have come under scrutiny in recent years due to the increased risk of side effects and addiction. Such risks may be even more prevalent in older adults.
Learn more about why older adults may be prescribed opioids, the risks involved, and the possible alternatives for chronic pain management a doctor can discuss with you.
Opioids, such as hydrocodone, methadone, and oxycodone, have been historically prescribed
Doctors may prescribe opioids to older adults for the following reasons:
- to treat an acute injury
- chronic pain management, such as osteoarthritis pain
- cancer pain treatment
- post-surgery pain management
While such health concerns may affect anyone, the chances of certain pain-related conditions, such as
In general, opioids are safe when used to treat short-term (acute) pain. Examples include pain related to a recent surgery or an injury. However, anyone who uses opioids may be at an increased risk of overdose or dependence.
It’s also important to know that taking opioids for any length of time may cause
- dry mouth
- nausea and vomiting
- itchy skin
Older adults who take opioids may also be at an
While the risks of side effects, overdose, and dependence apply to all adults, they may be higher for older adults. This is because older adults metabolize medications differently, with such substances staying in the body for longer.
Doctors may not recommend opioids for adults with a personal or family history of drug or alcohol use disorders.
Also, while doctors sometimes prescribe opioids for chronic pain, they may try other methods first. Due to the risks involved, opioids are best used for short-term treatment. Doctors should only prescribe them for chronic illnesses as a last resort.
In certain circumstances, such as surgery, pain medications may be necessary for a few days. However, a doctor may recommend other medications instead of opioids, particularly for mild to moderate pain.
In such cases, options may include one of the following over-the-counter (OTC) pain relievers:
For long-term pain, your doctor may refer you to a pain management specialist, where you may learn about
- physical therapy
- heat or cold therapy
- meditation and other relaxation techniques
- massage therapy
- yoga or tai chi
- spinal manipulation
- cognitive behavioral therapy (CBT)
Questions for my doctor about opioids
Due to the higher risk of side effects and dependence in older adults, it’s important to carefully consider the benefits versus risks of opioids with a doctor. Below are some key questions you can ask:
- Why might I need opioid treatment?
- Are there any other pain management options I can try?
- What are the side effects of opioids I should be aware of?
- What are the signs of possible dependence on, or increased tolerance to opioids?
- How long do I need to take opioids?
- Is there anything I should avoid while taking opioids (alcohol, other medications, supplements etc.)?
Any older adult who is prescribed opioids should be monitored carefully for both short-term and long-term side effects. This is especially important in considering the risk of opioid use disorder (OUD), which is more common in cases where doctors prescribe opioids for chronic conditions.
OUD describes the chronic use of opioids because of a dependence on them, despite no longer needing to take these medications.
While OUD is a health concern in the United States
If you suspect that you or a loved one may be experiencing OUD, it’s important to seek medical treatment. It’s best not to stop taking your prescription suddenly, as this can increase withdrawal symptoms and subsequent relapse.
Help for people with opioid use disorder
Opioids pose serious risks for anyone but especially older adults.
Despite the significant health risks opioids pose, these medications may still be a necessity in treating acute pain. In older adults, this may include acute pain caused by recent surgery or a serious injury.
Doctors should prescribe opioids at the lowest dose and for the shortest time possible. However, some doctors prescribe opioids for longer periods for chronic pain, such as those associated with arthritis, cancer, or other long-term illnesses.
It’s important to carefully weigh the pros and cons of opioid medication with a doctor before beginning a treatment regimen. You should also seek medical attention right away if you’re experiencing serious side effects or possible signs of OUD.