Older COPD Patients May Be Using Opioids Excessively

Researchers have found a high number of older adults with chronic obstructive pulmonary disease (COPD) are using opioids excessively, according to a study published in British Journal of Clinical Pharmacology.

An analysis of multiple provincial healthcare administrative databases and records for more than 120,000 adults in Ontario age 66 years and older with COPD found 70% of patients living in their own home and 55% of those in long-term care homes were given new opioid prescriptions. Opioids might be prescribed more frequently among this population to treat chronic muscle pain, breathlessness, and insomnia, according to the researchers.

"The new use of opioids was remarkably high among adults with COPD living in the community," study author Nicholas Vozoris, MD, a respirologist at St. Michael's Hospital, said in a statement. "The amount of opioid use is concerning given this is an older population, and older adults are more sensitive to narcotic side effects."

Older adults with COPD, and particularly those in long-term care homes, were being given multiple opioid prescriptions, early refills, and prescriptions that lasted more than 30 days, according to the findings. Dr Vozoris said that opioids may negatively affect lung health by reducing breathing rates and volume, and the population studied already have chronically compromised lungs due to their chronic lung disease.

He speculated that the excessive opioid use may be a result of patients looking for quick fixes to chronic pain and breathing problems combined with physicians believing narcotics may be a quick fix to COPD symptoms.

"Patients and prescribers should reflect on the way narcotics are being used in this older and respiratory-vulnerable population," Dr Vozoris said. "They should be more careful about when narcotics are used and how they're being used."