Opioids’ Effect On Older Adults With Respiratory Problems Worry Researchers

By Victoria Kim 10/07/15

Opioid use among older people is a growing concern.

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Older adults who have a problem breathing should be especially vigilant when taking opioid medication, a new study says.

The older population is more sensitive to narcotic side effects, one of which is respiratory depression, these drugs should be doled out carefully, said Dr. Nicholas Vozoris, study author and a respirologist at St. Michael’s Hospital in Toronto.

The researchers analyzed the records of more than 120,000 adults, 66 years and older in Ontario, who were diagnosed with chronic obstructive pulmonary disease, a chronic inflammatory lung disease that makes it difficult to breathe. It is caused by long-term exposure to irritants and increases one’s risk of developing heart disease, lung cancer, and a variety of other conditions.

“The amount of opioid use is concerning given this is an older population, and older adults are more sensitive to narcotic side effects,” said Dr. Vozoris.

The other potential narcotic side effects can be severe, especially for older adults. They include falls, fractures, confusion, memory impairment, fatigue, constipation, nausea, vomiting, and abdominal pain.

Dr. Vozoris explained that opioid medication like codeine, oxycodone, and morphine, may be prescribed more often among older adults with COPD to treat a variety of symptoms. “Sometimes patients are looking for what they think are quick fixes to chronic pain and chronic breathing problems,” he said. “And physicians sometimes believe that narcotics may be a quick fix to COPD symptoms.”

“Patients and prescribers should reflect on the way narcotics are being used in this older and respiratory-vulnerable population,” said Dr. Vozoris. “They should be more careful about when narcotics are used and how they’re being used.”

The new study, published in the British Journal of Clinical Pharmacology, observed that long-term care residents were given multiple opioid prescriptions, early refills, and prescriptions that lasted more than 30 days, raising concern about the potential for opioid abuse in this population.

The study found that between 2003 and 2012, 70% of those living at home received a new opioid prescription, while about 55% of those living in long-term care received a new opioid prescription.

There is evidence to suggest that opioids may harm lung health by reducing breathing rates and volume, which can result in decreased blood oxygen levels and higher carbon dioxide level, said Dr. Vozoris.

“This is a population that has chronic lung disease, and this drug class may also adversely affect breathing and lung health in people who already have chronically compromised lungs,” he said.

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