Tag Archives: narcotics

Experts with ties to drugmakers promoted prescribing opiates to older patients

Should older adults use powerful narcotics for ongoing pain relief?

This is a much-debated topic in geriatric circles. Last week, it burst into the public sphere with an article in the Milwaukee Journal Sentinel and MedPage Today by John Fauber and Ellen Gabler.

Their story focuses on a 2009 recommendation by the American Geriatrics Society that physicians consider prescribing opiates more often to seniors with moderate to severe pain.

Potential conflicts of interest may have compromised the Geriatric Society’s guidelines, Fauber and Gabler discovered. Five of 10 panel members who prepared the report had financial ties with opiate drugmakers and a sixth member began serving as a speaker for a drug company in the following year.

In another disturbing finding, Fauber and Gabler reveal that a pain guide endorsed by the Geriatrics Society and funded by an opioid drugmaker highlighted benefits of narcotics while downplaying risks – the potential for addiction, cognitive problems, overdosing, falls and fractures, and the enhancement rather than diminishment of pain.

“None of these side effects was included” in the document; instead, it claimed that “opioids allow people with chronic pain to get back to work, run and play sports,” they write.

The Geriatrics Society told the reporters that it stands behind the guide and is “deeply concerned that public policy may create barriers that will limit older adults’ access to pain medicine.”

In a sidebar, Fauber and Gabler examine a related issue in this controversy: the contention that alternatives to opioids – common over-the-counter drugs such as Aleve, Advil and Motrin – can have more deleterious health effects than narcotics. Continue reading

Seniors more vulnerable to painkillers’ risks

Mary Shedden, of The Tampa Tribune, delves into the dangers of prescription medicines in older people, whose bodies may be weaker and process medications differently than younger people.

She tells the story of a 62-year-old woman who says she was diligent about controlling her use of oxycodone following back surgery. Despite her efforts, she was found nearly comatose and, after a visit to the emergency room, had to spend several days detoxifying because of a buildup of prescription medications in her body. “As [Susan] Schubert’s body was getting older, its physiological ability to efficiently process medications was weakening and changing.”

Aging bodies can become more sensitive to the effects of drugs and some drugs can build up in the body.

Designed to heal, prescription drugs also carry certain risks, depending on a person’s health, weight, gender and, yes, age. Seniors accustomed to taking a drug for years may think changes are unnecessary, but human aging and an increased tolerance to a medication can alter its effect.

As Shedden explains, “drugs known to make a person drowsy can affect focus, balance and cognitive abilities already weakened by age.”

Shedden’s story, published before yesterday’s report from the Agency for Healthcare Research and Quality about the increase in medication- and drug-related hospital visits in people older than 45, is an interesting look into some challenges of geriatric pain management and drug dependence in an aging population.