Researchers are raising safety concerns about high rates of new opioid use among older adults with chronic obstructive pulmonary disease (COPD), according to a study published today in the British Journal of Clinical Pharmacology.
“The new use of opioids was remarkably high among adults with COPD living in the community,” said Nicholas Vozoris, MD, St. Michael’s Hospital, Toronto, Ontario. “The amount of opioid use is concerning given this is an older population, and older adults are more sensitive to narcotic side effects.”
The study is based on records for more than 120,000 adults in Ontario aged 66 years and older with COPD. Multiple provincial healthcare administrative databases were analysed at the Institute for Clinical Evaluative Sciences.
Between 2003 and 2012, 70% of those who were living in their own home were given a new opioid prescription, while about 55% of those living in long-term care homes received a new opioid prescription.
The study also found that older adults with COPD, especially those living in long-term care homes, were potentially using opioids excessively — meaning they were given multiple opioid prescriptions, early refills, and prescriptions that lasted more than 30 days.
“Sometimes patients are looking for what they think are quick fixes to chronic pain and chronic breathing problems,” said Dr. Vozoris. “And physicians sometimes believe that narcotics may be a quick fix to COPD symptoms.”
Dr. Vozoris said there was some evidence to suggest that opioids may negatively affect lung health by reducing breathing rates and volume, which can result in decreased blood oxygen levels and higher carbon dioxide levels.
“This is a population that has chronic lung disease, and this drug class may also adversely affect breathing and lung health in people who already have chronically compromised lungs,” he said.
“Patients and prescribers should reflect on the way narcotics are being used in this older and respiratory-vulnerable population,” added Dr. Vozoris. “They should be more careful about when narcotics are used and how they’re being used.”