Opioids in older adults raise the risk of falls, constipation, confusion and sedation, and benefit for chronic non-cancer pain is often modest.
Agree a specific function goal at the start, such as walking to the shops, and review against it regularly. Prescribe a laxative alongside, check for interacting sedatives, and plan a gradual taper when the goal is not being met. Abrupt withdrawal should be avoided.
- Set a function goal when starting an opioid.
- Review the goal at each repeat prescription.
- Co-prescribe a laxative and review other sedatives.
- Taper gradually if the goal is not met.
Why it matters
Without a goal, opioids in older people tend to continue indefinitely while harms accumulate.
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