Huang and Mallet identified a number of risks associated with long-term opioid therapy in an older adult. Although there is a high prevalence of chronic pain in older adults, the adverse effects of opioid drugs may be detrimental to the patient. The authors are from the University of Ottawa and Universite de Montreal in Canada.

Patient: older adult with pain


Parameters affecting the risks to the patient:

(1) dosage and potency of the opioid required for pain control

(2) duration of therapy

(3) patient comorbidities

(4) polypharmacy

(5) changes in body composition impacting pharmacokinetics

(5) nutritional and hydration status


Problems that may arise for an older adult:

(1) increased risk of falls

(2) cognitive impairment

(3) immunosuppression

(4) constipation

(5) respiratory depression

(6) histamine release

(7) urinary retention

(8) dry mouth

(9) nausea

(10) hyperalgesia

(11) dependence and substance abuse

(12) diversion to family members

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