Can older people safely take opioids, such as hydrocodone (Vicodin) and oxycodone (Percocet), to manage arthritis pain?
Answers from Paul Y. Takahashi, M.D.
An opioid isn't the first choice for treating chronic conditions such as arthritis. Aside from cancer pain, opioids more commonly are reserved for short-term pain relief, such as after injuries or surgeries. When other means of relieving arthritis pain haven't helped, opioids may be prescribed. But safety and effectiveness are issues.
Opioids may not be helpful. Even when they are, people often develop a tolerance to opioid pain medications over time, so the effect of the medication may diminish after taking the same dosage for several months.
Opioids have risks that may be particularly serious for older people, including:
- Sedation. Opioids can cause sleepiness or mental clouding, which can dramatically increase the risk of fractures caused by falls.
- Disordered breathing. Higher doses of opioids can result in slower or shallow breathing patterns, especially during sleep.
- Heart problems. Some opioids increase the risk of heart attack or heart failure.
- Constipation. Many older adults are already dealing with this problem and opioids generally just make it worse.
Nov. 25, 2014
- AskMayoExpert. Clinical opioid use. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- Rosenquist EW. Overview of the treatment of chronic pain. http://www.uptodate.com/home. Accessed Oct. 29, 2014.
- Franklin GM. Opioids for chronic noncancer pain: A position paper of the American Academy of Neurology. Neurology. 2014;83:1277.
- Soloman DH, et al. The comparative safety of analgesics in older adults with arthritis. Archives of Internal Medicine. 2010;170:1968.
- Rohren CH (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 30, 2014.