Alert
Close

Introducing AARP RealPad: The Wi-Fi Tablet That Makes It Easy to Share, Learn, Connect and Play. Learn more

HIGHLIGHTS

Open
10,000 Games Galore Sweepstakes from AARP
Celebrate Hispanic Heritage Month

AUTO BUYING PROGRAM

AARP Auto Buying Program

DRIVER SAFETY

Piggy bank on the road - AARP Driver Safety

Take the new AARP Smart Driver Course!

Contests and
Sweeps

Safe Driving in 2014 Sweepstakes

Learn how AARP Driver Safety can help you stay safe—and enter for a chance to win $1,000. See official rules. 

Download the ipad App

AARP-iPad-ePub-app

KEEP BRAIN ACTIVE!

AARP Games - Play Now!

Learning Centers

Get smart strategies for managing health conditions.


Arthritis

Heart Disease

Diabetes

Most Popular

Viewed

Nothing has been viewed

Popular Medications No Longer Recommended for Chronic Pain

New guidelines say opioids like codeine are safer for patients over 75.

Not all physicians agree with the panel’s decision. Many pain specialists contend that NSAIDs still have a place in the medicine cabinet. Some even argue that the recent emphasis on the dangers of NSAIDs has pushed the pendulum too far, causing physicians to overlook the potential risks of opioids.

“Personally I still [prescribe] NSAIDs, even in the older generation,” says Mehul Desai, M.D., a pain management specialist in Washington D.C. “I think all of this attention [on the harmful effects of NSAIDs], to some extent has been—I don’t want to say completely undue—I think it’s been overblown.”

Mark Fendrick, M.D., a researcher and physician at the University of Michigan, thinks using caution is appropriate, but he doesn’t agree that NSAIDs should be thrown out in favor of opioids for every patient of a certain age.

“The use of even low-dose narcotics in the elderly tends to be frowned upon in almost every situation,” Fendrick says.

If a patient has no other cardiovascular risk factors but has a history of stomach ulcers and gastrointestinal bleeding or takes blood thinners, for example, Fendrick feels a traditional NSAID along with a medication—like Nexium or Prilosec—that reduces gastric acid production is still warranted. For patients who do have cardiovascular risk factors such as high blood pressure or coronary artery disease, Fendrick argued, an NSAID like naproxen may still be safe. In most studies, the drug naproxen, found in the brand Aleve, caused a smaller increase of heart attack risk than other NSAIDs.

Addiction Risks Overstated?

Fendrick, like Desai, worries that the new guidelines proposed by the Geriatrics Society overlook the side effects and potential harm of opioids. Unlike acetaminophen (Tylenol’s generic name), which can damage the liver, or NSAIDs, opioids haven’t been linked with any long-term organ damage. But there are known side effects, including constipation, nausea, and sedation, that can cause problems for many people who take them.

“Particularly in the elderly population, there are concerns over sedation and neurological effects,” Desai says.

Opioids, which work by blocking pain receptors in the brain, also present a risk of abuse and addiction. They are considered one of the most commonly abused drugs in America, even among people over the age of 65. But Ferrell says the panel looked at the research and found that most people who become addicted to painkillers already had a history of substance abuse. And the relatively low rate of addiction and abuse among the elderly convinced the guidelines’ authors that opioids were safe.

Anderson, the pain management doctor, calls the fear of opioids a “faith-based system” that dates back to research on criminals from more than two centuries ago. The fact that opioids are heavily regulated, while some NSAIDs can be bought without a prescription, also contributes to a view among the public that NSAIDs are safer. But Anderson thinks opioids are often the better choice; he also says that most of his patients can be fully functional on the drugs.

Laura Johnson agrees. A patient of Anderson’s for several years, the 52-year-old Forest Lake, Minn., nonprofit director suffers from multiple sclerosis, fibromyalgia, migraines and arthritis. She uses a fentanyl patch that releases the narcotic throughout the day.

Topic Alerts

You can get weekly email alerts on the topics below. Just click “Follow.”

Manage Alerts

Processing

Please wait...

progress bar, please wait

Tell Us WhatYou Think

Please leave your comment below.

Topic Alerts

You can get weekly email alerts on the topics below. Just click “Follow.”

Manage Alerts

Processing

Please wait...

progress bar, please wait

Discounts & Benefits

From companies that meet the high standards of service and quality set by AARP.

Reading eyeglasses eyemed 6 membership benefit health

Members save 25% on orders of $200 or more and get 25% off lens upgrades at glasses.com.

AARP/Walgreens Wellness Bus Stops in Clarksdale, MS

Members can get exclusive points offers from Walgreens and Duane Reade.

Member Benefits

Join or renew today! AARP members receive exclusive member benefits & affect social change.