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High Opioid Use In Elderly With Chronic Obstructive Pulmonary Disease, Study Finds

This article is more than 8 years old.

Results from a new report published in the British Journal of Clinical Pharmacology revealed that clinicians could be overprescribing opioids to older adults suffering from chronic obstructive pulmonary disease (COPD), a progressive lung disease that makes it difficult for individuals to breathe.

According to the paper's results, 70% of those who were living in their own home were given a new opioid prescription between 2003 and 2012. Only 55% of those living in long-term care homes during the same time period received a prescription from their clinician for a new narcotic drug.

Study author Dr. Nicholas Vorzoris, a respirologist at St. Michael's Hospital, said in an interview that his team found "remarkably high use of new opioid prescriptions" while conducting their study. He also suggested that "opioids were also frequently prescribed in ways suggestive of excessive use."

"I am hoping that by alerting clinicians to the way opioids are prescribed to older adults with COPD, and reminding them of potential opioid side-effects that can occur in this population, they will reflect on their own prescribing practices and use more discretion when prescribing this medication class in this vulnerable population," Vorzoris said.

Researchers, using several provincial healthcare administrative databases, analyzed the records of more than 120,000 adults in Ontario age 66 and older with COPD.

Practioners prescribe opioids in patients with COPD to alleviate chronic muscle pain and reduce refractory shortness of breath and cough, Vorzoris said. Additionally, opioids are sometimes mixed in with either aspirin or Tylenol "in order to try and offer pain relief by more than one mechanism."

"Some opioids contain caffeine in them, with the hopes that the stimulating properties of caffeine will help counteract possible sedation side-effects," he noted.

Family physicians prescribed the majority of opioids to the group, with about 88% of new prescriptions a mixture of opioids and non-opioids.

"Although opioids might help reduce refractory shortness of breath and cough in COPD patients, there are also some scientific studies showing that opioids may be associated with respiratory harm, as well as increased rate of death," he said. The clinical impact and safety of opioids in COPD is a controversial topic, in my opinion."

He added: "As a next step to our current work, we are conducting a study evaluating whether or not new opioid prescriptions are associated with increased respiratory exacerbations and death among older adults with COPD."

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