FEATURED MEDICAL EDUCATION TOPIC: Chronic Pain and Substance Use in the Older Adult:  Interventional Options and Risk Management

What is the problem?

Chronic pain affects 27.6% of adults aged 65 and older—more than one in four older Americans. At the same time, approximately 15% of community-dwelling adults over age 50 receive an opioid prescription each year, and among those prescribed opioids for chronic pain, up to 35% report misusing their medication. In older adults, problematic opioid use can have serious consequences, including sedation, cognitive impairment, falls, fractures, and constipation, while first-time treatment admissions for opioid use disorder are also increasing in this population. These trends are particularly important for physicians to recognize because older adults may be more vulnerable to the adverse effects of opioids, and symptoms of problematic use can be overlooked or mistaken for normal age-related changes. Early identification, careful prescribing, and appropriate monitoring can help physicians balance effective pain management with the prevention of opioid-related harm and support safer, more individualized care for older patients.

The practice gap: identifying substance use disorder in older adults when its signs are routinely attributed to aging, and building pain treatment plans that account for age-related pharmacokinetics, polypharmacy, and interventional alternatives to escalating opioids.

Proposed Learning Objectives

At the conclusion of this activity, the learners will be able to:

• Identify characteristics of older patients with chronic pain that warrant a multidisciplinary approach 
• Select interventional pain approaches appropriate to individual patients and evaluate the evidence supporting newer techniques 
• Screen for atypical presentations of substance use disorder in older adults using validated geriatric screening tools, differentiating them from cognitive decline, depression, and medical comorbidity 
• Individualize treatment for substance use disorders, accounting for age-related pharmacokinetic changes and polypharmacy

If your medical staff needs an update on substance use and pain in the older patient population, consider contacting our office to book a speaker at 714-505-4777 or info@speakersnetwork.com.

REFERENCES

https://www.sciencedirect.com/science/article/pii/S2773065423001128

https://pmc.ncbi.nlm.nih.gov/articles/PMC8421190