Painkiller Side Effects Linked to Increasing Hospitalizations for Elderly Patients: Study

More and more elderly patients are suffering severe injury or dying due to side effects of powerful pain medications they are taking, according to the findings of a new study. 

In a report published in the Journal of the American Medical Association (JAMA) on October 22, researchers indicate that between 1993 and 2012, there has been a dramatic increase in hospitalizations among older patients prescribed opioid painkillers.

The study was a statistical brief published recently by the Agency for Healthcare Research and Quality (AHRQ), which also found the largest increase in the rate of hospitalizations during that period was in patients over the age of 85 years. This was followed by patients aged 65 to 84 and then followed by patients age 45 to 64.

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Study authors also noted Medicare experienced the biggest average annual increase in the number of narcotic painkiller-related hospitalizations.

Researchers indicate that as people age, they are more likely to have chronic pain, but are less likely to abuse narcotic painkillers, such as Oxycodone or Vicodin. Younger patients tend to abuse the opioid prescription drugs more often. Typically, the overdose rate of narcotic painkillers significantly decreases after the age of 65.

Despite an older patient’s reduced risk for overdose, they are more likely to experience adverse effects after taking opioids, including falls, liver impairment, cardiac toxicity and cognitive impairment. In some cases, even death.

The risk of suffering a cardiovascular event for codeine users increased after 180 days of use. The risk of death for Oxycodone and codeine users increased after a mere 30 days use.

“Even in the 65- to 84-year-olds, what you’re dealing with are patients with multiple comorbidities and a body that has less resilience,” Wilson Compton, MD, deputy director of the National Institute on Drug Abuse, said in the JAMA report.

Doctors Overprescribing Painkillers to Elderly

Authors of the analysis suggested that many doctors may be prescribing opioids too soon, before trying other therapies, such as acetaminophen, non-steroidal anti-inflammatory drugs or physical therapy. In addition, they are also aggressively prescribing large doses when unnecessary, the researchers found.

“We certainly have a situation where we have an over reliance on opioids, particularly for long-term painful conditions,” said Compton, “This is an important public health issue, and the elderly are a major part of the population that’s impacted.”

The analysis comes on the heels of a federal study published in September that concluded prescription overdose deaths from opioid painkillers, like hydrocodone and others, continued to rise. The U.S. Centers for Disease Control and Prevention (CDC) report found narcotic painkiller overdose deaths quadrupled in the U.S. Between 1999 and 2011.

Another report published by the American Academy of Neurology (AAN) earlier this month called for new dosing guidelines for prescription opioids.

The policy the AAN is calling for would require patients taking painkillers for chronic pain to see a specialist if they are taking daily doses of options of 80-120 mg morphine equivalent per day. The report also said there was little evidence to support continued use of opioids for long periods of time.

1 Comments

  • BrianOctober 23, 2014 at 10:35 am

    This study brings important light to a problem that is endemic to our society: the dangers of over prescription of drugs to patients particularly the elderly. In my experience careless medical care providers are too willing to treat the symptoms of pain rather than treat the underlying cause. Pain medications and NSAIDS have very real risks and the elderly represent a particularly vulnerable popul[Show More]This study brings important light to a problem that is endemic to our society: the dangers of over prescription of drugs to patients particularly the elderly. In my experience careless medical care providers are too willing to treat the symptoms of pain rather than treat the underlying cause. Pain medications and NSAIDS have very real risks and the elderly represent a particularly vulnerable population when it comes to these drugs. Because of underlying changes in their ability to metabolize these drugs elderly patients are vulnerable to developing toxicity. Tylenol for example is know to produce adverse effects on the liver particularly in this who consume alcoholic beverages. Motrin and other NSAIDs can cause renal impairment as well as gastrointestinal problems. All drugs of course pose risks of hypersensitivity reactions such as Stevens Jonson Syndrome and Toxic Epidermal Necrosis. In our practice we have seen disastrous complications including respiratory failure , brain damage and death from adverse reactions to narcotic pain patches. These patches are particularly dangerous when used in the elderly and in patients who are not " narcotic tolerant" . The best bet is to try to avoid pain meds whenever possible. When conservative therapies fail and drugs are necessary it is best to use them only as necessary and then only in the smallest dose that will help alleviate symptoms and for the shortest duration consistent with obtaining relief.

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