Opioids, a class of prescription pain relievers, have increased in prevalence in the last decade, with an estimated 191 million prescriptions dispensed in 2017 alone, according to the Centers for Disease Control and Prevention (CDC).

The risk of side effects and addiction has increased in recent years, and these common medications have come under scrutiny. Older adults may be at higher risk of such risks.

You can learn more about the risks and possible alternatives for chronic pain management if you talk to a doctor.

Opioids work by preventing your body from processing pain. This can work in various areas of the body, including the brain and the skin.

Opioids, such as hydrocodone, methadone, and oxycodone, have been historically prescribed to help treat moderate to severe pain.

Older adults may be prescribed drugs for the following reasons.

While such health concerns may affect anyone, the chances of certain pain-related conditions, such as osteoarthritis and cancer, may increase with age. This, in part, explains an increase in long-term use of opioids among older adults.

In general, opioids are safe when used to treat short-term (acute) pain. Examples include pain related to a recent surgery or an injury. However, anyone who uses opioids may be at an increased risk of overdose or dependence.

It’s also important to know that taking opioids for any length of time may cause side effects, such as:

  • dizziness
  • It is too sleepy.
  • The mouth is dry.
  • Nausea and vomiting.
  • It is a problem of the colon.
  • There is confusion.
  • itchy skin
  • sweating
  • Depression.

Older adults who take opioids may also be at an increased risk of cognitive changes, breathing problems, and falls leading to bone fractures.

Opioids may also result in greater tolerance to the medication and increased sensitivity to pain. Dependence can occur when you experience symptoms of withdrawal. The chances may be greater if you take opioids for longer than your doctor recommends.

While the risks of side effects, overdose, and dependence apply to all adults, they may be higher for older adults. This is because older adults metabolize medications differently, with such substances staying in the body for longer.

Adults with a family history of drug or alcohol use disorders may not be recommended for opioids.

You also should not take opioids with benzodiazepines, as this may lead to fatal side effects. Examples of benzodiazepines include:

Also, while doctors sometimes prescribe opioids for chronic pain, they may try other methods first. Due to the risks involved, opioids are best used for short-term treatment. Doctors should only prescribe them for chronic illnesses as a last resort.

In certain circumstances, such as surgery, pain medications may be necessary for a few days. However, a doctor may recommend other medications instead of opioids, particularly for mild to moderate pain.

Options may include one of the OTC pain reliefs.

For long-term pain, your doctor may refer you to a pain management specialist, where you may learn about alternatives to OTC and prescription pain medications, such as:

Questions for my doctor about opioids

It is important to consider the benefits and risks of a drug when talking to a doctor. You can ask some key questions.

  • Why should I be receiving treatment for opiate use?
  • Is there any other pain management options that I can try?
  • What are the side effects of drugs?
  • What are the signs of dependence on drugs?
  • How long should I take the drugs?
  • Is there anything I should avoid while taking drugs?

Any older adult who is prescribed opioids should be monitored carefully for both short-term and long-term side effects. This is especially important in considering the risk of opioid use disorder (OUD), which is more common in cases where doctors prescribe opioids for chronic conditions.

OUD describes the chronic use of opioids because of a dependence on them, despite no longer needing to take these medications.

While OUD is a health concern in the United States more generally, it’s also important to consider that older adults may be at an increased risk. This may be due to taking opioids for longer periods, or dependence that results from metabolizing the drugs differently than a younger adult might, resulting in higher levels of the drug in the body.


If you suspect that you or a loved one may be experiencing OUD, it’s important to seek medical treatment. It’s best not to stop taking your prescription suddenly, as this can increase withdrawal symptoms and subsequent relapse.

Treatment for OUD in older adults may involve medications to help alleviate withdrawal symptoms. Opioid replacement therapy and CBT are other options that may help.

Help for people with opioid use disorder

If you need help with OUD, consider calling SAMSHA’s National Helpline, a free and confidential information and referral service, at 800-662-4357 (HELP). You can also find behavioral health services in your area through SAMSHA or the Healthline FindCare Tool.

Older adults are at higher risk of being harmed by opiate drugs.

The risks of the drugs are significant, but they may still be needed in treating acute pain. Acute pain may be caused by surgery or a serious injury in older adults.

Doctors should prescribe the lowest dose of the drug. Some doctors prescribe opioids for chronic pain, such as those associated with arthritis, cancer, or other long-term illnesses.

Before starting a treatment regimen, it is important to carefully weigh the pros and cons of the medication. If you are experiencing serious side effects or are seeing signs of OUD, you should seek medical attention immediately.