The Department of Health and Human Services says the number of elderly adults who abuse opioids is projected to double between 2004 and 2020. Clearly, this forgotten demographic of the opioid epidemic deserves more vigilant care from their health care providers.
An unfortunate fact of life is that as the body ages, it hurts. More than 80 percent of adults over the age of 65 suffer multiple chronic aches and pains from causes like rheumatism, arthritis, hypertension and diabetes, to name a few. In addition, many older Americans undergo surgeries, sometimes several of them, for which they are prescribed opioids for pain.
Shannon Skowronski, a specialist at the Health and Human Services Administration on Aging says, “The prevalence of chronic and acute conditions that might result in pain, along with the physiological changes in the body as you grow older, that’s really complicated. … Aging is associated with unique biological, psychological, and social factors that all play an important role in pain management.”
A report from the Administration for Community Living says that although older adults have lower rates of abusing opioids than young adults, when they do have opioid-use disorder, they appear to be at a higher risk of death.
There is no single cause for the rise in opioid abuse among the elderly. Studies show that some take more than prescribed to try to hold their pain at bay. Some “self-medicate” by getting prescriptions from friends or family without proper instructions. But a primary reason, according to research reported in The Atlantic magazine, is that doctors and pharmacists often fail to warn their elderly patients of the dangers of opioid use.
Investigators with the University of Michigan’s National Poll on Healthy Aging surveyed 2,000 Americans between the ages of 50 and 80 about what their health care providers told them when prescribing opioid medication. The group generally knew how often to take the medication, but the majority could not recall their doctors or pharmacists talking about “the risk of addiction, the risk of overdose, or what to do with leftover pills.” Further, 40 percent said their doctors didn’t talk to them about the side effects of opioid use or guide them on when to cut back on pain medications.
Further research by the Drug Policy Alliance shows that when doctors prescribe pain relief medication to older patients, they may not go into much detail because they assume only younger patients are at risk.
Of course, doctors and pharmacists are not solely to blame for miscommunication with their older patients. The Centers for Disease Control and Prevention confirms what experience and common sense have always dictated: Growing older often also means the brain does not receive or recall information with as much agility as it once did.
Finding solutions is tricky. No single cause for opioid abuse among the elderly means there is no single answer. But health care providers should be the first line of defense, meaning doctors and pharmacists should begin by adequately explaining the significant effects associated with opioid use so that patients, or those who may care for them, fully understand. Doctors should likewise follow up with their older opioid-using patients on a more regular basis than they do for younger patients.
Older patients could also benefit from accelerated research into holistic and alternative pain management approaches, including doctor-prescribed and pharmacy-fulfilled medical marijuana. Scientifically tested and effectively monitored solutions should then be carefully explained by health care providers to senior patients.
The opioid abuse crisis knows no age. But awareness, vigilance and common sense can blunt its effects on the elderly.