Chronic opioid use higher among vulnerable elders

  • Oh G & al.
  • PLoS One
  • 1 Jan 2019

  • curated by Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • The prevalence of opioid use among older adults in the United States was lower than that reported in past studies, and lower than reports from other countries.
  • However, vulnerable populations were more likely to use opioids, including those who were black, were older, used multiple medications, had comorbid chronic health problems, or used antidepressants.

Why this matters

  • Despite the commonality of chronic pain in older adults (more than half of the elderly US population reports pain), pain management is challenging in this population because of the high incidence of polypharmacy and adverse events.

Study design

  • Study evaluated 13,059 participants (aged ≥65 years) who enrolled in National Alzheimer’s Coordinating Center.
  • Funding: National Institute on Aging.

Key results

  • At initial visit, there were 498 (3.8%) and 284 (2.2%) users of any and strong opioids, respectively.
  • Significant predictors of prevalent-chronic (opioid use at baseline and consistently later) vs minimal (no/low opioid use) use of any opioids were:
    • black race (aOR, 1.92; 95% CI, 1.41-2.61),
    • older age (aOR, 1.83; 95% CI, 1.28-2.61),
    • use of ≥5 medications (aOR, 2.52; 95% CI, 1.25-5.08),
    • diabetes (aOR, 1.44; 95% CI, 1.05-1.97), and
    • use of antidepressants (aOR, 1.89; 95% CI, 1.46-2.44).

Limitations

  • Participants not classified by continuous long-term opioid use.

Coauthored with Antara Ghosh, PhD