Experts are becoming concerned about the increasing use of opioid medications among older adults with chronic obstructive pulmonary disease (COPD), according to a new study published today in the British Journal of Clinical Pharmacology. COPD is a progressive lung disease that makes it difficult to breathe.
“The new use of opioids was remarkably high among adults with COPD living in the community,” said Dr. Nicholas Vozoris, a respirologist at St. Michael’s Hospital. “The amount of opioid use is concerning given this is an older population, and older adults are more sensitive to narcotic side effects.”
For the study, researchers analyzed the records of more than 120,000 adults in Ontario age 66 and older with COPD. Multiple provincial healthcare administrative databases were analyzed at the Institute for Clinical Evaluative Sciences.
Between 2003 and 2012, 70 percent of those who were living in their own home were given a new opioid prescription, while about 55 percent of those living in long-term care homes received a new opioid prescription.
The findings also showed that older adults with COPD, especially those living in long-term care homes, were potentially using opioids excessively; meaning they were given multiple opioid prescriptions, early refills, and prescriptions that lasted more than 30 days.
Opioids, such as codeine, oxycodone, and morphine, might be prescribed more frequently among older adults with COPD to treat chronic muscle pain, breathlessness and insomnia, said Vozoris. Common side effects of opioids include falls and fractures, confusion, memory impairment, fatigue, constipation, nausea, vomiting, and abdominal pain.
“Sometimes patients are looking for what they think are quick fixes to chronic pain and chronic breathing problems,” said Vozoris. “And physicians sometimes believe that narcotics may be a quick fix to COPD symptoms.”
Vozoris said there was some 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 levels.
“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,” said Vozoris.
The majority of opioid medications were prescribed by family physicians, with about 88 percent of new prescriptions being a mixture of opioids and non-opioids, such as Percocet, Endocet and Lenoltec.
“Patients and prescribers should reflect on the way narcotics are being used in this older and respiratory-vulnerable population,” said Vozoris. “They should be more careful about when narcotics are used and how they’re being used.”
Source: St. Michaelâ€™s Hospital