Opioids & Caring for Older Adults

The Opioid Epidemic was proclaimed a crisis in 2017, and this year we are working hard to learn how to best approach our clients and loved ones when it comes to opioid use. Pain management is a huge issue when it comes to getting older, and the line between treating pain and addiction is very, very fine.

According to Michael Wasserman, MD, CMD, in “Opioid Use in Older Adults, Care or Crisis?” (2017), there are various options available for managing pain. Rather than opioids, one can take Acetaminophen which, if taken regularly (around-the-clock), works 70% of the time. If you are in the other 30% and this is not effective, you may try something else such as NSAIDs. These are most effective for inflammatory problems.

There are other medications to consider before opioids. Many used for other purposes, such as SSRIs and antidepressants, can help conditions such as neuropathy. There are also topical medicines and injections which may help.

Alternatives to pharmacologic treatment, called complementary and alternative medicine, can be beneficial to some people. These may include osteopathic manipulation, chiropractic treatment, acupuncture, and massage therapy. Physical & occupational therapy, and also cognitive behavioral therapy, are helpful in some cases. Our staff has received training in EFT, Emotional Freedom Techniques Tapping, which has proved helpful for chronic pain as well.

Getting exercise, including options such as tai chi or yoga, can help with pain. And let’s not forget the option of spirituality as an aide, including prayer and meditation.

All of these alternatives can aid in the easing of chronic pain, but there are times in which opioids are the best option for the individual situation. When a person’s quality of life is affected and nonopioid medications/treatments have been ineffective, opioids may be necessary.

According to Wasserman (2017), “The following goals are key to the effective use of opioids:

• Pain control with limited side effects;
• Around-the-clock dosing;
• As needed for breakthrough pain;
• Avoidance of polypharmacy;
• Recognition of pain triggers, particularly in the cognitively impaired; and
• Therapy targeted toward individual pain assessment.”

These are all positive goals in managing the use of these drugs so that a person’s pain is handled, but they do not become severely addicted.

Our tagline is, “We are like wedding planners for growing older.” When our care managers assess a new client, they try to learn all about their background and medical history, and work with their doctors and other health professionals to create a holistic plan to address chronic pain. The hope is that more people can avoid opioid use by utilizing some of the methods previously mentioned.

Chronic pain is a tough thing to overcome. Talk with someone about it – a family member, a friend, a doctor – or call Debra Levy Eldercare Associates, and start the conversation with an Aging Life Care manager. Let’s beat opioid addiction in 2018.