Opioids are a class of drugs that treat pain symptoms caused by surgery, injury, and diseases. However, they can also cause chemical dependence and addiction in some people. Opioid dependence can be caused by the long-term use of prescription opioids or misusing them in high doses.
Unfortunately, opioids are often used for long periods of time in people with chronic pain, especially the elderly. Opioid use may be dangerous in older people that might take other medications that suppress the nervous system. Plus, opioid dependence can lead to uncomfortable withdrawal symptoms and addiction.
Finding viable alternatives to opioids is important for many. According to the 2018 National Survey on Drug Use and Health, prescription pain reliever misuse was the second most common illicit drug use in the U.S.
As many as 9.9 million people misused opioids in the past year before the survey. In 2018, there were around 1.7 million people who developed new prescription opioid use disorders in 2018. Also in 2018, 25 percent of adults over age 65 had at least one opioid prescription filled in 2018.
Opioids are helpful for some people, and the vast majority of people who use prescriptions as directed by a medical professional do not develop a substance use problem. However, everyone is different, and it’s important to have serious conversations about prescriptions with your doctor before you decide to take or not take a prescription that’s been legally given to you.
It is important to ask your doctor about possible side effects, alternatives, and tapering strategies. When you’re prescribed an opioid, or if you’ve been taking one for a while, ask your doctor if there are side effects you should look out for and if you should be worried about dependence.
You should also ask about your plan for getting off of your prescription opioid. Is this a long or short-term treatment? Is there a plan to taper off the drug?
If you’re taking a benzodiazepine or another central nervous system depressant, taking an opioid could be life-threatening. Benzodiazepines aren’t recommended for older people, but they are still commonly prescribed to people over age 65. Always check and double-check that your doctor is aware of the prescriptions you’re taking when you receive a new prescription.
Opioids are one of the most effective medications for moderate to severe pain, but they also come with risks. Exploring alternatives can help you avoid some of the pitfalls of long-term opioid use like chemical dependence and withdrawal. To find the best options, you’ll need to work with your doctor, but there are some things you should be aware of. There are a few other medications or activities that can be used to mitigate pain symptoms in some cases, including:
Ibuprofen is commonly used for muscle pain and inflammation. It’s an over-the-counter drug that can be effective at relieving certain kinds of pain. However, it may not be useful for every type of pain. Ibuprofen can cause stomach aches and even intestinal bleeding if they’re taken in high doses or too often. Acetaminophen and aspirin, which are found in Tylenol and Bayer respectively. These can also treat pain in different ways, and some patients use these at different times for different purposes. For the most part, these drugs only cause mild side effects, but anything you take often could cause harmful effects that should be monitored.
Physical therapy is an important step in recovery for many people. Physical therapy can help improve mobility and alleviate pain symptoms for people who have had surgery, nerve damage, or strokes. This may involve sessions with a physical therapist or a physician with a specialization in physical therapy. Physical therapy may involve whirlpools, exercises, or working through pain to strengthen injured areas.
Exercise is an important part of health for people of any age. Like physical therapy, exercise can help strengthen muscles in and around areas of pain. Maintaining your strength and mobility as you age can help you keep your independence longer, avoid needing wheelchairs or other mobility devices, and it can allow you to enjoy more physical activities. You can work out independently, and that would be cheaper. But a personal trainer may be able to identify specific exercises that may relieve pain. They can also offer insight to help you reach your workout goals.
A massage therapist can help ease tension that can cause pain in and around injured or affected areas. Massage therapy can be part of physical therapy, but you may also seek it independently. In many cases, pain is caused by muscle tension that can be relieved by a massage.
Athletes have long used heat and ice to relax sore muscles and joints. Icing and heat both have positives and drawbacks and they often show mixed results in scientific studies. However, icing in particular has shown to decrease swelling and inflammation, which is a common source of pain.
People hear about psychology in the context of pain and think it’s referring to the “it’s all in your head” explanation. This can be an easy way to write off pain for people on the outside. But it can be very frustrating for people with mental health issues who are experiencing very real pain. However, just because your mental health can contribute to pain symptoms doesn’t mean the pain isn’t real. Issues like anxiety and depression can cause real physical symptoms in the body.
Your brain and body are all connected by the nervous system, so it makes sense that a problem in one area can impact others. Depression, in particular, has been known to cause vague aches and pains, as well as localized joint and muscle pain. Depression can also cause fatigue and malaise that could prevent you from being active, which can worsen pain symptoms.
Depression and anxiety are problems older adults face when they go through common things like the death of a loved one, retirement, or frightening medical issues. Addressing these problems can improve both mental and physical health conditions.
The Cycle of Pain is a term used to describe behaviors and consequences that are caused by and contribute to pain. Getting caught in this cycle can worsen pain or perpetuate it. When you experience painful symptoms that last a long time, it may start to affect your mentality and your lifestyle. Exercise can help ease pain symptoms by loosening and strengthening muscles and releasing endorphins. But exercise is the last thing you might want to do when you’re experiencing pain.
A sedentary lifestyle can lead to increased pain and mental health consequences. As your mood and your mobility go down, your ability to move and exercise to break the cycle will also diminish. Breaking the cycle may involve learning what you can safely do to increase your physical activity and working through painful symptoms to improve them.
The Cycle of Pain is critical for older people to avoid. Elderly people may be more vulnerable to this cycle because of decreased mobility, but there’s often a way to break the cycle with your own capabilities.
American Psychiatric Association. (2017, January). What Is Addiction? from https://www.psychiatry.org/patients-families/addiction/what-is-addiction
SAMHSA. (2018). Key Substance Use and Mental Health Indicators in the United States. from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf
Singh, D., Barani Lonbani, Z., Woodruff, M., Parker, T., Steck, R., & Peake, J. (2017, March 7). Effects of Topical Icing on Inflammation, Angiogenesis, Revascularization, and Myofiber Regeneration in Skeletal Muscle Following Contusion Injury. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5339266/
Juergens, S. M., M.D. (1993, August 01). Problems With Benzodiazepines in Elderly Patients. from https://www.mayoclinicproceedings.org/article/S0025-6196(12)60643-0/fulltext
Trivedi, M. (2004). The link between depression and physical symptoms. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC486942/