An analysis of government data shows more than 500,000 Medicare recipients received high doses of opioids in 2016, with the average dose exceeding the manufacturer’s recommended amount.
So, older Americans are a group being hit by this crisis that many may not have expected.
John Evard didn’t exceed his prescription, but he certainly knew about the opioid issue.
The 71-year-old retired corporate tax attorney was prescribed oxycodone after surgery on a TMJ joint, aimed at helping with horrible ear pain he had from an infection in his ear.
He said the surgery was by all accounts a success.
The issue was that the pain didn’t go away, and he needed the pain meds.
“I needed some increased amount as the pain got worse and worse. And what you learned is that your pain receptors fill up and they can no longer take the help that the opioids provide. And I found myself in that do loop,” said Evard.
Soon he said the oxycodone dictated his day and took away his life.
“I couldn't have a social life. I couldn't play go out with my friends. I couldn't go to restaurants. I couldn't go to parties, we couldn’t have parties at our home,” explained Evard.
Dr. Irene Wu, the Assistant Director UCLA Comprehensive Pain Center in Los Angeles said opioids can be great painkillers for acute pain under certain circumstances, but patients and doctors need to be aware of what could happen.
“I think our bodies become very dependent and tolerant to these medications quite quickly,” said Dr. Wu.
Dr. Wu said she advises most caution if opioids are used for chronic pain.
When dealing with the senior set, she said there is additional concern.
She said, “I think older patients are more prone to side effects because they metabolize medications much more slowly.” That puts them more at risk for respiratory distress and cognitive impairment.
A government survey found “hospital stays involving opioid overuse” grew 5-fold between 1993 and 2012 for people over age 45 -- much higher than any other age group.
Evard said he only followed his prescription instructions and was on the opioids for about eight months. By then, basically housebound, he knew he was in trouble and checked into rehab.
“I decided to go to rehab just because I had no other solution. My life was ending. I mean, I didn't have anything to do, anything really reason to live, except just living for the more medications,” said Evard.
He added that the withdrawal symptoms were brutal but worth it.
Evard said he’s doing well now and manages his pain with non-opioid medications and feels he gets the best relief from aerobic exercise.
Dr. Wu said there are many tools in the pain management toolbox.
“For older patients I think that we should introduce them to what we call multimodal pain management, meaning the use of muscle relaxants, anti-inflammatories -- which all have much fewer side effects than the typical opioids may have,” she explained.
Dr. Wu said she also recommends acupuncture and physical therapy both as a potential alternative or additive to opioids for pain management.
She stressed that there are differences between drug “dependence” and drug “addiction.”
John said he was dependent -- not addicted -- to the opioids, but he still needed help to quit.
If you or someone you care about may have a problem, head to the Substance Abuse and Mental Health Services Administration Helpline for assistance.
