A study released in early 2015 by the National Safety Council finds that even when used properly, opioids pose a safety hazard to all patients; especially the elderly. As part of a broader look at the consequences of opioids in general, the paper’s author, Donald Teater, MD, makes several recommendations to lower opioid-related risks.

Opioids Can Be Dangerous

Contrary to peoples’ prevailing opinions of opioids being generally safe, there are significant side effects from opiates resulting in major morbidity and mortality in the U.S. annually. Physical side effects include gastrointestinal distress, respiratory depression, cognitive impairment, and even endocrine imbalances involving decrease in sex hormones leading to osteoporosis and hypogonadism. There’s also opioid-associated brain change that can lead to a state of hyperalgesia where the neurons become more responsive to pain and actually increase the person’s perception of pain. In addition, more than 16,000 people die every year due to opioid overdose.

Opioids in Elderly Adults

The study Psychological and Physical Side Effects of Pain Medications found that risk of death and unintentional injury is particularly high for elderly adults. Adults over the age of 65 aren’t just at risk of potential addiction; the treatment itself can cause further health problems.

According to the study, adults over 65 years of age who take opioids, such as Oxycontin, are 87% more likely to die and 68% more likely to be hospitalized than those taking non-opioid pain medications such as NSAIDs, or nonsteroidal anti-inflammatory drugs, like Motrin. In fact, there was 64% higher risk of falls and three times greater risk of hip fractures for elderly adults taking opioids. Interestingly, the elderly taking opioids had equal rate of GI bleed as compared to those taking NSAIDs. Though it can be difficult to separate correlation from causation here, such findings certainly indicate a link between opioid use and higher morbidity/mortality rates.

Opioids in Workers’ Compensation

The assumption that opioids will result in increased physical activity more quickly and improve rehabilitation was not supported in studies looking at disability and recovery. A workers’ compensation claim study involving back pain found increased opioid doses directly correlated with length of disability for injured workers. Interestingly, opioids prescribed within 6 weeks of injury doubles the risk of disability one year later, which may in fact place opioids as one of the major risk factors for future disability in workers’ compensation.

Recommendations for Improvement

The paper suggests the medical community should re-evaluate opioid prescription habits. It asks medical providers to work with insurance companies to develop mechanisms that encourage using opioids rarely and only in select circumstances for brief periods while facilitating incorporation of more non-drug pain treatments, such as counseling and physical therapy to address chronic pain symptoms. Most certainly, the complexity of managing pain requires a comprehensive holistic approach by providers.

Deborah Hersman, the President and CEO of NSC, said in a statement (quoted in Business Insurance) that “more Americans overdose on prescription painkillers than on heroin and cocaine combined… Without an honest dialogue, we’ll continue to see a cycle of addiction and overdose that has made opioid painkiller use a public health crisis.”

Paradigm Outcomes’ biopsychosocial approach to pain management short-circuits the cycle of long-term opioid use and abuse. To learn more, visit the Paradigm Outcomes website or follow us on Facebook, Twitter, and LinkedIn.