Prescribing opioids to seniors: It's a balancing act
The national conversation about the opioid epidemic has mostly focused on young people who buy drugs illegally on the street. But the scrutiny of opioids has also changed the way doctors are prescribing medications to the elderly, to ease their pain from arthritis, cancer, neurological diseases and other illnesses that become more common in later life.
Over the past decade, a growing number of seniors have been prescribed opioids including hydrocodone, codeine and oxycodone. A recent study found that in 2011, 15 percent of seniors were prescribed an opioid when they were discharged from the hospital.
As concern grows about a national opioid epidemic, however, some seniors now find it harder to get medications they need from doctors and pharmacies. Some medical practices refuse to accept patients already taking an opioid for pain.
Beyond the obvious dangers of addiction, opioids can pose serious risks for seniors. Common side effects include constipation, breathing problems, confusion and problematic interactions with other medications. Seniors taking opioid medications are also four to five times more likely to suffer a fall or fracture than those taking a non-opioid pain medication.
But opioids can also be a critical tool in treating debilitating pain that leaves seniors immobilized and homebound. Carla Perissinoto, a geriatrician at the University of California San Francisco, says prescribing opioids to seniors is often about helping them maintain their independence. Perissinoto recently spoke with California Healthline about the delicate balancing act of prescribing opioids. This conversation has been edited for clarity and length.