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chronic-painAccording to the CDC, from 1999 to 2014 opioid prescriptions have quadrupled and over 165,000 people have died from prescription opioids.

Some of those 165,000 people are the elderly who have been over-medicated with opioids. The elderly have a very different and diminished ability to metabolize pharmaceuticals and this is not always taken  in to proper account.

Improper pain management, whether over medication or under medication is the genesis of much suffering for the elderly with chronic pain.

The CDC has recently released new guidelines for opioid use for chronic pain. While those in active cancer therapy, palliative care and end of life care aren’t included in these guidelines, chronically ill elders certainly are.

Click here to see the new CDC guidelines.

List of most common opioids:  Hydrocodone (Vicodin), Morphine, Oxycodone (Oxycontin), Oxymorphone, Methadone, Fentanyl.

Common side effects to watch for:  Nausea and vomiting; dry mouth; constipation; sedation; dizziness;  depression; urinary retention; itching; sweating; respiratory depression; hypersensitivity to pain; seizures; delirium; myoclonus.

The families and caregivers of elders with chronic pain also need to understand these principles so they can advocate for best practices and help their loved one’s pain management. Here is a simple, short and practical summary of the CDC guidelines:

  1. Use non-opioid therapies first.
  2. Start low and go slow.
  3. Monitor closely and follow up.

Further information on pain management in the geriatric population can be found at:

Pain Management In The Elderly (PDF)

Pharmacological Management of Persistent Pain in Older Persons (PDF)

World Health Organization Ladder (PDF)

Pain Management in the Elderly Population: A Review

If you need help managing the care of your loved one and implementing any of these steps, we are here for support.  Give Grace Care Management a call at (760) 789-9177 for a free consultation.

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