In the past 20 years, the rate of hospitalization among seniors related to opioid overuse has quintupled. Since 2000, the rate of deaths from drug overdoses has increased 137%, including a 200% increase in the rate of overdose deaths involving opioids (opioid pain relievers and heroin).
A study of Medicare recipients found that in 2011, about 15 percent were prescribed an opioid when they were discharged from the hospital. Three months later, 42 percent were still taking the pain medicine.
These numbers give direct insight into how some seniors become addicted.
Of course, not everyone using opioids will become addicted. And some individuals need opioids to manage long term severe pain. However, anyone taking opioids over time will develop a physical tolerance.
Opioid Tolerance and Addiction in Older Adults
Opioids are known to have an inverse effect on pain relief over time. That is, in the beginning opioids are very effective as prescribed for relieving pain. Over time the pain relief from opioid decreases, even at the same dose level.
This effect is known as developing ‘tolerance’ to the opioid. Tolerance happens even if the user does not become addicted. Because of the tolerance effect, it is not realistic to think that opioids will remain effective on low doses indefinitely.
In the past decade, a reliance on prescribing ‘time release’ opioids almost guaranteed addiction if severe pain was involved. This is because the drugs did not relieve pain for a full 12 hours; and increasing doses were needed to control pain. This was a setup for becoming addicted.
How Can Senior Adults Become Addicted Without Knowing It?
How could anyone become addicted without knowing it?
Are these adults simply not paying attention?
Or, are they knowingly abusing prescription opioid pain medications?
Let’s Look at a Typical Case of Older Adult Opioid Addiction
The patient is an older male, retired, age 65+. During his working life, this individual was steady and hard-working with no previous addictions or alcoholism. This individual has no particular emotional or financial stress currently; and is not taking any pain medications.
Older man goes into hospital for a procedure or surgery that requires post-procedure pain relief.
Man is prescribed pain meds after surgery, including Oxycontin.
Over time, man needs more pain medication to relieve the pain.
Tolerance has developed. He needs a higher opioid prescription dose to combat pain.
Taking higher doses relieves pain – but the man becomes rapidly feeble; trouble with balance and walking.
Man becomes bed-ridden. Former low impact exercise program is no longer pursued. An under-reported side effect of pain medication is accidental falls with serious outcomes.
His physician, noting the man’s age and recent surgery, concludes the man is simply experiencing the effects of old age.
An M.D. 2nd opinion suggests that opioid addiction could be the cause; suggests a rehab for older men.
The man is shocked. And totally horrified.
He is not a ‘dope fiend’. Everyone knows that only the morally bankrupt become addicted to drugs. Certainly not a man taking medication as prescribed.
Are there alternatives to opioids for post-surgical pain? A new evidence-based clinical practice guideline of pain management from the American Pain Society, appearing in The Journal of Pain, gives 32 recommendations to help clinicians achieve optimal pain management following surgery.
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Questions? Arrowhead Lodge Recovery Has Answers
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