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The Opal Program for Senior Opioid Dependency

By Jeanne Wei, M.D., Ph.D., Executive Director UAMS Donald W. Reynolds Institute on Aging University of Arkansas for Medical Sciences

   When picturing someone with opioid use disorder, the first image in your mind might not be one of your grandmother, an older relative or an older friend. Unfortunately, there’s a good chance they should be among your first thoughts.

   Opioid use disorder occurs when someone becomes physically dependent on opioids and has an increasing tolerance for higher doses. Arkansas has the second highest opioid prescribing rate in the United States, according to the Centers for Disease Control and Prevention.

   For patients aged 90 and older, opioids are the fourth most commonly prescribed medicine. We know something needs to be done. In our Longevity Clinic at the UAMS Donald W. Reynolds Institute on Aging, the median age of our patients is around 86 years. We see a number of patients who are dependent on opioids.

   The risk for side effects from opioids is much greater for patients aged 60 and older who have medical conditions such as breathing issues and/or heart problems, depression, memory and sleep problems, and alcohol or substance abuse. Their use of opioids to treat chronic pain can lead to negative side effects like nausea, constipation, respiratory changes, falls, walking difficulty and bladder issues.

   To prevent and reduce opioid use among seniors, the Reynolds Institute has established the Opioid Prevention for Aging & Longevity (OPAL) program. The program, funded through a federal grant, provides educational materials to distribute at public events.

   The program provides statewide public education to inform seniors about the risks of continued opioid use. The program works to bring awareness of opioid use disorder among seniors and to educate professionals authorized to write opioid prescriptions about appropriate doses for mature adults.

   Educating seniors and physicians about prescribing opioids doesn’t benefit only seniors. Reducing opioid use among seniors would also help restrict the supply of prescribed opioids that somehow make their way into illegal drug sales when other people in their homes take them from the seniors.

   Opioid use in mature adults makes it difficult to accurately diagnose dementia or other cognitive disorders because opioids commonly can cause confusion, worsen memory impairment and may result in confusion and fall injuries. Over a period of time, opioid usage can become ineffective in reducing pain or may worsen chronic pain and could possibly lead to an accidental overdose.

   We don’t want anybody to get hurt by continuing to take those medicines long term. Research has shown that you only need between three days to seven days of a prescription of opioid medication after a surgery or procedure or injury.

   Beyond just a few days of opioid use, patients should try to use mindfulness, meditation and even hypnosis to cope with the mental and emotional stress of chronic pain. More than one study has shown that combinations of drugs like ibuprofen and acetaminophen can be just as effective at treating pain.

   Through the OPAL program, the UAMS Reynolds Institute is committed to combatting the opioid crisis. We’re leading the effort and helping seniors to become part of the solution.

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