Among the more mature use of opioids
Part of aging means you can deal with the pain and sorrow. To treat the pain, your doctor may prescribe it opioid. You will be joined by a large group of older adults: 9% of adults aged 65 and over take opioids in exchange for pain.
Opioids are one of the most powerful types mine relief. They can be very effective, especially in the face of severe pain, says Dr. Cary Reid, an associate professor of medicine at Weill Cornell Medical College in New York and a researcher in pain management.
But they also have serious side effects, and older people are at greater risk. If not taken as prescribed, opioids can cause addiction or even more addiction. “Doctors, we are constantly questioning whether opioids do more harm than good,” Reid says.
Why do so many adults take opioids
“As you get older, so does your body,” he says anesthesiologist Halena M. Gazelka, MD, Rochester, MN, President of the Mayo Clinic Enterprise Opioid Stewardship Program. It can be a painful situation, for example arthritis, back injuries, or cancer.
If you need surgery for any of these problems, your doctor may prescribe an opioid to help improve it. “Opioids are drugs that treat severe acute pain,” Reid says. This is also why they are given chronic pain, usually as a last resort.
All of this explains why someone over the age of 65 is three times more likely to take an opioid than someone who is about 20 years old. Nearly 20% of seniors fill an opioid prescription in a given year.
How opioids affect adults differently
Older adults frequently metabolize or process opioids. “As we get older, our body has more fat,” Reid says. This raises the level of an opioid in the bloodstream. Your kidneys the drug may not be effectively filtered so that it can last longer in your body.
Moreover, opioids may interact with other medications taken by the elderly, such as sleeping pills, kidnappings, and nerve pain. “That’s why adults have side effects compared to someone in their 20s or 30s,” Reid says. In one study, nearly 30% of men age 65 and older had a reaction to taking an opioid.
Common side effects include:
Risk of opioid misuse
Opioids increase brain chemicals called endorphins, which relieve pain and cause feelings of pleasure. These feelings of good feeling are the place to create misuse, abuse, and addiction.
Misuse is when you use your doctor the way your doctor didn’t want to, says Benjamin Han, MD, assistant professor of geriatrics, gerontology and palliative care at UC San Diego School of Medicine. For example, you take an extra dose for back pain. Or you take a painkiller to relax sleep better.
Misuse of opioids is a growing problem among adults. According to one study, 7% of adults aged 50 and over admitted that they had misused an opioid prescription. This can cause dangerous side effects, Reid says. It may create a tolerance where you need a higher dose of the medicine to feel good.
Misuse opens the door to opioid use disorder. Then opioids affect your life. You can’t go out or reduce it. Or your use affects your family’s ability to work or care for you. Reid says other red flags are about wanting drugs or taking them in dangerous situations, such as when you’re driving.
Prescribing Opioids to Older Adults
Over the past two decades, rising opioid dependence and overdoses have created a public health crisis. Experts once thought that adults were not likely to misuse opioids, but they found that this was not the case. Gazelka says anyone of any age can be addicted to opioids.
As doctors and patients became aware of these problems, opioid prescriptions fell nationwide. But they are still the most common in the older ones. Often, elderly patients do not have enough opportunities to get hurt, Gazelka says. Either they don’t know or they can’t receive any other treatment, for example physical therapy, acupuncture, and nerve blocks.
On the other hand, there is also concern that some doctors are too cautious when it comes to prescribing opioids. “People who don’t get these drugs may be able to take advantage of them,” Reid says. Or a person with severe pain may refuse an opioid because they are concerned about addiction.
How to take opioids safely
If your doctor suggests an opioid, talk about the risks and side effects. It’s important to start the conversation, Reid says. Less than half of the elderly with an opioid prescription said their doctor had warned them of addiction or overdose, according to a survey.
Ask the following questions:
- Do I have another option instead of an opioid?
- Have you prescribed the lowest dose possible?
- What side effects should I expect and how can I manage them?
- How do we decide if this drug works? Can we try it if he doesn’t do something else?
- How many times do you need to see me to keep track of my progress?
- Will this opioid interact with any of my other medications?
- Are you worried that I might become addicted?
- How will taking this opioid affect my daily life, such as driving?
While you are taking an opioid, tell your doctor if you experience any side effects or changes in your pain. You will also need follow-up appointments to make sure your doctor’s benefits outweigh the risks of taking an opioid.