Literature DB >> 23841571

Under treatment of pain: a prescription for opioid misuse among the elderly?

Maria A Levi-Minzi1, Hilary L Surratt, Steven P Kurtz, Mance E Buttram.   

Abstract

OBJECTIVE: To examine the demographic, physical, and mental health characteristics; current drug use patterns; motivations for use; and diversion sources among elderly prescription opioid misusers.
DESIGN: Mixed methods design.
SETTING: Research field offices, or senior or community center offices in South Florida.
SUBJECTS: Individuals aged 60 and over reporting past 90-day prescription medication misuse; only prescription opioid misusers (N = 88) were included in the final analysis.
METHODS: The Global Appraisal of Individual Needs was the main survey instrument. A subsample of elderly reporting substantial prescription drug misuse were chosen for the in-depth interview (N = 30).
RESULTS: The mean age was 63.3. Fifty percent reported ever being admitted to a drug treatment program; several endorsed recent illicit drug use: powder cocaine and/or crack (35.2%), marijuana (30.7%), heroin (14.8%). The majority reported past year severe physical pain and discomfort (86.4%), and misuse of their primary opioid for pain (80.7%); over half (52.3%) obtained their primary opioid from their regular doctor. Qualitative data highlight the misuse of prescription opioids due to untreated or undertreated pain. Participants with primary opioid misuse for pain had over 12 times higher odds of obtaining the medication from their regular doctor (odds ratio [OR] = 12.22, P = 0.002) and had lower odds of using a dealer (OR = 0.20, P = 0.005).
CONCLUSIONS: Findings suggest that this group of elderly participants often misuse their own prescriptions for pain management. This study highlights the need to educate prescribing professionals on appropriate pain management for older adults while still being sensitive to issues of substance abuse and dependence. Wiley Periodicals, Inc.

Entities:  

Keywords:  Older Adults; Opioids; Pain Management; Substance Abuse

Mesh:

Substances:

Year:  2013        PMID: 23841571      PMCID: PMC3834188          DOI: 10.1111/pme.12189

Source DB:  PubMed          Journal:  Pain Med        ISSN: 1526-2375            Impact factor:   3.750


  36 in total

1.  Quality indicators for pain management in vulnerable elders.

Authors:  J Chodosh; B A Ferrell; P G Shekelle; N S Wenger
Journal:  Ann Intern Med       Date:  2001-10-16       Impact factor: 25.391

2.  Patterns of illicit drug use and opioid abuse in patients with chronic pain at initial evaluation: a prospective, observational study.

Authors:  Laxmaiah Manchikanti; Kim S Damron; Carla D McManus; Renee C Barnhill
Journal:  Pain Physician       Date:  2004-10       Impact factor: 4.965

Review 3.  Misuse of and dependence on opioids: study of chronic pain patients.

Authors:  Meldon Kahan; Anita Srivastava; Lynn Wilson; Douglas Gourlay; Deana Midmer
Journal:  Can Fam Physician       Date:  2006-09       Impact factor: 3.275

Review 4.  Prescription drug misuse/abuse in the elderly.

Authors:  John W Culberson; Martin Ziska
Journal:  Geriatrics       Date:  2008-09-01

5.  Pain management in frail, community-living elderly patients.

Authors:  F Landi; G Onder; M Cesari; G Gambassi; K Steel; A Russo; F Lattanzio; R Bernabei
Journal:  Arch Intern Med       Date:  2001 Dec 10-24

Review 6.  Drugs of abuse and the aging brain.

Authors:  Gayathri J Dowling; Susan R B Weiss; Timothy P Condon
Journal:  Neuropsychopharmacology       Date:  2007-04-04       Impact factor: 7.853

7.  Mechanisms of prescription drug diversion among drug-involved club- and street-based populations.

Authors:  James A Inciardi; Hilary L Surratt; Steven P Kurtz; Theodore J Cicero
Journal:  Pain Med       Date:  2007-03       Impact factor: 3.750

8.  Motivations for non-medical prescription drug use: a mixed methods analysis.

Authors:  Khary K Rigg; Gladys E Ibañez
Journal:  J Subst Abuse Treat       Date:  2010-07-29

9.  Assessment of pain: a community-based diary survey in the USA.

Authors:  Alan B Krueger; Arthur A Stone
Journal:  Lancet       Date:  2008-05-03       Impact factor: 79.321

10.  Prescription opioid use in the rural Appalachia: a community-based study.

Authors:  Jennifer R Havens; Robert Walker; Carl G Leukefeld
Journal:  J Opioid Manag       Date:  2008 Mar-Apr
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  15 in total

1.  Heroin use onset among nonmedical prescription opioid users in the club scene.

Authors:  Hilary L Surratt; Steven P Kurtz; Mance Buttram; Maria A Levi-Minzi; Maria E Pagano; Theodore J Cicero
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3.  Pharmacological Approaches for the Management of Persistent Pain in Older Adults: What Nurses Need to Know.

Authors:  Fabio Guerriero; Ruth Bolier; Janet H Van Cleave; M Cary Reid
Journal:  J Gerontol Nurs       Date:  2016-12-01       Impact factor: 1.254

Review 4.  Managing Pain in the Setting of Opioid Use Disorder.

Authors:  Barbara St Marie; Kathleen Broglio
Journal:  Pain Manag Nurs       Date:  2019-10-21       Impact factor: 1.929

5.  Prescription Opioid Misuse in US Older Adults: Associated Comorbidities and Reduced Quality of Life in the National Epidemiologic Survey of Alcohol and Related Conditions-III.

Authors:  Ty S Schepis; Sean Esteban McCabe
Journal:  J Clin Psychiatry       Date:  2019-11-19       Impact factor: 4.384

6.  Factors associated with prescription opioid misuse in adults aged 50 or older.

Authors:  Yu-Ping Chang
Journal:  Nurs Outlook       Date:  2017-11-29       Impact factor: 3.250

7.  Primary care providers' experiences with urine toxicology tests to manage prescription opioid misuse and substance use among chronic noncancer pain patients in safety net health care settings.

Authors:  Rachel Ceasar; Jamie Chang; Kara Zamora; Emily Hurstak; Margot Kushel; Christine Miaskowski; Kelly Knight
Journal:  Subst Abus       Date:  2016       Impact factor: 3.716

8.  Enhanced recovery programme reduces opiate consumption in hip hemiarthroplasty.

Authors:  Rupert Talboys; Mandy Mak; Nitin Modi; Nabil Fanous; Steven Cutts
Journal:  Eur J Orthop Surg Traumatol       Date:  2015-11-11

9.  The influence of undertreated chronic pain in a national survey: Prescription medication misuse among American indians, Asian Pacific Islanders, Blacks, Hispanics and whites.

Authors:  Michelle Johnson-Jennings; Bonnie Duran; Jahn Hakes; Alexandra Paffrath; Meg M Little
Journal:  SSM Popul Health       Date:  2020-03-14

10.  Spinal manipulative therapy and exercise for older adults with chronic low back pain: a randomized clinical trial.

Authors:  Craig Schulz; Roni Evans; Michele Maiers; Karen Schulz; Brent Leininger; Gert Bronfort
Journal:  Chiropr Man Therap       Date:  2019-05-15
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