Why might a doctor hesitate to prescribe opioids to seniors?

Doctors might hesitate to prescribe opioids to seniors for the following reasons: 

• When older people start using opioids at higher doses or chronically, they often experience serious side effects, such has respiratory depression (slow and ineffective breathing), physical dependence, increased falls, confusion and cognitive decline.
• Doctors are concerned about how these medications can cause a decline in function and memory, which can increase risk of seniors being institutionalized (assisted living and nursing homes), especially if they are unable to care for themselves. 
• Opioids put older adults at a higher risk of falls, which can lead to major consequences. Some consequences are immediate -- such as death from a brain bleed. In other people, a fall can result in a hip fracture, which can be very difficult for older adults to recover from. 
• Long-term opioid use can put people at a greater risk for developing a tolerance, meaning the therapeutic impact of the medication decreases with time. As the medication’s impact decreases, higher doses are needed to provide pain relief, creating a greater risk for dependence. 
• When people are trying to taper their pain medications, they can become more sensitive to the sensations of pain and have difficulties coping physically, emotionally and mentally. 
• Opioid use can mask underlying mental health symptoms, such as anxiety and depression. Patients may rely on opioids to induce relaxation, which can cause a numbing effect on their emotions.

Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site.  In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider.