Are Opioids in Your Future? Another Side of Heath Care
Carol S. Heape, MSW, CMC
If you are considering a hip or knee replacement (or other major medical surgery), it’s quite probable that an opioid will be prescribed for pain. According to David L. Albright, Hill Crest Foundation endowed Chair in Mental Health, opioids bind the body’s natural opioid receptors to the reward center in the human brain, diminishing pain and simultaneously producing feelings of relaxation and comfort. For those experiencing pain (physical, mental or a combination) the ability to access nearly instant pain relief and emotional comfort are powerful draws (SW Advocates, Feb-Mar 2019).
A recent statistic states that one in seven Americans will experience a substance abuse disorder in their lifetime (SW Advocates, Feb-Mar 2019). Older adults are included in this number. Opioid misuse is lower in older adults than younger individuals but even so, the rate of opioid misuse among older adults nearly doubled between 2002 and 2014 (Healthcare Cost & Utilization Project (HCUP), 9/2018). The report states in 2016 a third of more than 40 million people enrolled in Medicare Part D (Prescription Drug coverage) received prescription opioids and a substantial number received higher doses than recommended for prolonged periods of time.
“Rural older adults are dying from the opioid epidemic at a higher rate than older adults in the nation as a whole. “(Aging Today,4/2019) Aging baby boomers often have more casual attitudes toward drug use although almost half of opioid deaths are due to prescribed medications. This ASA article “Rural Older Adults Hit Hard by Opioid Epidemic” state that opioid mis-use poses “a serious threat to the health of older adults, whose bodies can no longer metabolize drugs quickly placing them at risk of serious side effects (see listed side effects below in this article).
Older adults statistically take more prescription drugs than younger people. This can increase the likelihood of drug interactions and adverse effects associated with the use of opioids. With the use of opioids, a person over 65 year of age has a greater percentage of visits to a hospital ER (more than twice as often) and also has a higher percentage of in- patient hospital stays directly related to opioid related stays.
Although opioid medication can be quite effective in addressing high pain levels, there are potential and likely side effects that can affect you. As you consider and prepare for surgery, be sure and discuss the following with your surgeon or prescribing physician:
Six Issues to Consider
- What is being prescribed and for how long?
- What are the normal side effects with this medication?
- At what point should you notify the prescribing physician about side effects you’re experiencing?
- What are the dangers of being prescribed an opioid?
- Is there an alternate medication that will address the pain sufficiently?
- What are dangers of long term use and addiction particularly if there is a history of addiction?
Side Effects That Can Happen
- Inability to Think Clearly
- Poor Balance/Dizziness
- Prolonged extreme fatigue
- Short term memory loss
- Inability to remain safely alone
- Lack of appetite
Talk to the physician before the surgery date. Be sure you understand the issues around this type of medication. Don’t wait until you’re out of surgery, home and have difficulty with multiple side effects above.
With a large share of older adults living in some form of pain, they and society at-large must consider how to balance between providing patients with safe and effective pain treatments but not overprescribing and risk misuse.
Carol S. Heape, MSW, CMC is the Founder of Elder Options, Inc. Since 1988, Elder Options has been supporting older adults, the disabled and their families by creating care services that enable A Life Lived Fully Every Day.