With all the news about the opioid epidemic, there's an unexpected group in trouble: older people.
In fact, an analysis of government data shows more than 500,000 Medicare recipients received high doses of opioids in 2016, with the average dose exceeding the manufacturer's recommended amount.
John Evard didn't exceed his prescription, but he certainly knows about the opioid issue. The 71-year-old retired corporate tax attorney was prescribed oxycodone after surgery on a TMJ joint, aimed at helping with horrible ear pain he had from an infection in his ear.
The surgery, he says, was by all accounts a success. The issue: The pain didn't go away, and he needed the pain meds. And then, he says," I needed some increased amount as the pain got worse and worse. And what you learned is that your pain receptors fill up and they can no longer take the help that the opioids provide. And I found myself in that do loop."
Soon, he says, the oxycodone dictated his day and took away his life. "I couldn't have a social life. I couldn't play go out with my friends. I couldn't go to restaurants. I couldn't go to parties, we couldn't have parties at our home."
Dr. Irene Wu, the Assistant Director UCLA Comprehensive Pain Center in Los Angeles, says opioids can be great painkillers for acute pain under certain circumstances, but patients and doctors need to be aware that, "I think our bodies become very dependent and tolerant to these medications quite quickly."
Dr. Wu says she advises most caution if opioids are used for chronic pain. And when dealing with the senior set, she says there is an additional concern. "I think older patients are more prone to side effects because they metabolize medications much more slowly," putting them more at risk for respiratory distress and cognitive impairment.
A government survey found "hospital stays involving opioid overuse" grew 5-fold between 1993-2012 for people over age 45, much higher than any other age group.
John says, he only followed his prescription instructions and was on the opioids for about eight months. By then, basically housebound, he knew he was in trouble and checked into rehab.
"I decided to go to rehab just because I had no other solution. My life was ending. I mean, I didn't have anything to do, anything really reason to live, except just living for the more medications." He adds the withdrawal symptoms were brutal but worth it.
John says he's doing well now and manages his pain with non-opioid medications, and insists he gets the best relief from aerobic exercise.
Dr Wu says there are many tools in the pain management toolbox, including, "For older patients I think that we should introduce them to what we call multimodal pain management, meaning the use of muscle relaxants, anti inflammatories, which all have much less side effects than the typical opioids may have."
Dr. Wu also recommends acupuncture and physical therapy both as a potential alternative or additive to opioids for pain management.
She also stresses that there are differences between drug "dependence" and "addiction."
John says he was dependent, not addicted to the opioids, but he still needed help to quit.
If you or someone you care about may have a problem, head to the Substance Abuse and Mental Health Services Administration Helpline for assistance.