As we get older, our bodies change in ways that affect our ability to clear and process medications. Some of these physiological changes include decreased metabolic rate, decreased lean body mass, and decreased total body water. Additionally, the kidneys and liver can have difficulty clearing metabolites of opioid and other drugs. These are natural changes, but important factors to consider when increasing the dose or frequency of your prescription. Older age alone does not disqualify a patient from taking opioids, but it may require further evaluation before beginning a treatment plan involving opioids.
Along with changes in physiological processes, older adults are more likely to have chronic conditions for which they are receiving other prescription medications. The term “polypharmacy” is used to describe the use of multiple medications at the same time to treat a single condition or coexisting conditions. When taking multiple medications, it is possible to see interactions between drugs. Adding opioids to a treatment plan that already includes other medications can further increase the chance of experiencing drug to drug interactions. These potential interactions are why it is critical to provide your doctor with an accurate and updated medical history. In 2016, researchers found that patients over 65 years of age filled an average of 24 prescriptions per year. Twice as many as patients age 19-64 (12.7 Rx filled) and six times more than patients age 0-18 (4.3 Rx filled).
For some older patients, opioids may not be an option. However, for those to do use opioids, it is important to remember that with age our bodies respond differently to prescription medication for a variety of reasons. As always, follow the plan designed by your doctor, and be sure to communicate if you are noticing any unwanted or unexpected side effects.
Look for our next post where we discuss how to use Naloxone, a drug that can reverse the effects of an opioid overdose.