Opioids are a class of medication that relieves chronic pain. They alter cyclooxygenases mediated pain-signaling pathways to the brain and how the brain responds to pain through the neuronal green pathways. Opioids are used to relieve pain arising from dental procedures and toothache, surgery –major or minor, and chronic pain conditions associated with cancer among others. Some medications, including cough medicines, also contain opioids.
The elderly often experience suppressed sensitivity to pain due to neuronal degeneration. Episodes of pain among the elderly population is construed as age mediated and not from any underlying pathologies (Dowell , Haegerich , & Chou, 2016). Often, the pain that the seniors experience is neither treated nor recognized. The elderly also tend to ignore the pain due to pre-occupation with situations they feel are more important compared to the pain. Medical practitioners mostly avoid prescribing opioids for pain among the elderly. They are restrained by existence of underlying concurrent pathologies, including diabetes complications, fall injuries, and impaired circulation (Holle , 2018).
Medical practitioners are cautious when prescribing opioids due to increased vulnerability to renal and other liver diseases. The elderly often experience a reduction in fast pass metabolism and a general reduction in clearance of opioids in the kidneys predisposing them to the risks of drug accumulation (Wu, 2018). Such increments in circulatory quantities of drugs and reductions in renal clearance could cause poisoning resulting from overdose (Holle , 2018). Therefore, practitioners should monitor the glomerular filtrate and creatinine clearance in elderly persons receiving therapeutic doses of opiates. In cases of renal and hepatic insufficiency, long stay periods are recommended between administrations of the medication. Additionally, medical practitioners should endeavor towards discouraging the elderly from saving medication that is unused to prevent the risk of medication doglegs including duplicate therapy.
References
Dowell , D., Haegerich , M. T., & Chou, R. (2016). CDC guideline for prescribing opioids for chronic pain (Vol. 65). United States: MMWR Recomm Rep.
Holle , L. M. (2018). Pharmacist perspective on the CDC guideline for prescribing opioids for chronic pain. Retrieved 05 14, 2019, from www.modernmedicine.com/sites/default/files/images/DrugTopics/UCONN/drtp0317 _CE.pdf
Wu, A. (2018). Special Considerations for Opioid Use in Elderly Patients With Chronic Pain . US Pharm , 43, 26-30.