Talk to Seniors

Last year, the AARP Bulletin’s special report “America’s Addiction to Pain Pills” put a spotlight on a side of the opioid epidemic that isn’t always mentioned: opioids and older adults. The report highlighted that nearly one-third of all Medicare patients, or close to 12 million people, were prescribed opioid painkillers by their physician in 2015. That same year, 2.7 million Americans over the age of 50 abused painkillers, meaning they took them for reasons or in amounts beyond what their doctors prescribed.

In 2014, Washington had the second highest rate of opioid-related hospital stays when looking at data nationally for those 65 and older. Prescription monitoring program data in Snohomish County, meanwhile, show that among those with at least one opioid prescription in the last quarter of 2017, the number markedly increases among those 55 and over. This points to the need to talk with seniors about potential risks of opioid prescriptions, and what they can do to prevent misuse and abuse in their home.

Understand the Increased Risks of Falls & Injuries

Falls are the leading cause of death among older adults in Washington, claiming nearly 900 lives each year. Now, evidence suggests that older adults taking opioids are 4 to 5 times more likely to fall than people taking non-steroidal anti-inflammatory drugs (NSAIDS) such as aspirin and ibuprofen.

Scott Dorsey has spent 27 years responding to medical emergencies in Snohomish County. The deputy chief at Fire District 7 knows how medications taken by people — blood thinners, for example — can affect patients and make them more susceptible to falls and related injuries.

He recently examined data from medical calls in the fire district this year, focusing his search on falls involving people 65 and older. He found 20 cases where the patients had been prescribed pain medications prior to their injuries.

Ask Questions About Medications

The Washington Health Alliance encourages treating short-term pain with over-the-counter pain relievers, physical therapy and exercise. If prescribed an opioid pain reliever, the Alliance recommends taking the lowest dose possible for the shortest period of time and talking with your doctor about options.

It is always a good idea to ask questions, Dorsey said. Pharmacists can be particularly helpful. So can the relatives of those who are prescribed pain medications, he said.

“We just really have to watch what our loved ones are on and ask questions,” he said, adding that advocacy is “often what makes the difference.”

In addition to taking the prescription as indicated, it’s important to know what other medications seniors are taking. Opioids can have dangerous interactions with muscle relaxers, some antibiotics, benzodiazepines (like Xanax and Valium) and others.

Monitor Opioid Treatments

In some cases, opioids are both necessary and beneficial to helping older adults maintain their health and independence, according to Carla Perissinoto, a geriatrician at the University of California San Francisco.

“I have patients who, unless they take their opioid, really cannot get out of bed,” she said in a recent interview with Kaiser Health News. “And if that small dose of opioid is going to help them get out of bed and move around their house and cook for themselves, then that is absolutely worth doing. Their biggest risk is going to be if they stop moving and (decline more). That’s going to have a bigger consequence on their health than prescribing an opioid at a reasonable dose and with close supervision.”

Prevent Misuse and Abuse in the Home

Many times, older adults are more susceptible to theft in the home due to the number of medications laying around. There is also an increased risk of poisonings, either from patients confusing medications or from young children getting into prescriptions.

These risks can all be reduced by following three simple steps:

• Clearly mark medications.
• Lock them up in cabinets, bags or boxes.
• Safely dispose of them through MED-Project once they are no longer needed.