The O.P.A.L. Education and Awareness Program
In response to the national opioid epidemic, under the direction of Dr. Jeanne Wei and Dr. Gohar Azhar, the O.P.A.L. Program is providing adults aged 65 and older and their caregiver(s) an opportunity to learn more about opioid pain medications, non-opioid pain medications and integrative medicine therapies like Tai Chi, Yoga, mindfulness meditation and other therapies for the management of chronic pain. In addition, we are educating older adults about the dangers of over-the-counter medications that are not approved by the primary physician. Resources such as information on over-the counter medications, how to prevent falls and how to protect yourself and others from the Covid-19 infection may also be found on this website and are free. Please browse by topic at your convenience.
What are Opioids?
Opioids are a group of pain medications used in the treatment of moderate to severe pain. However, they are not intended for long-term use. When prescription opioids are used appropriately, they can be an important part of managing acute or chronic pain, although they are associated with some serious side effects, particularly in older adults. There are non-opioid medications and integrative therapies which are discussed below on this page. These other therapies may be as beneficial in managing chronic pain without the serious side effects of opioids.
Opioids in Arkansas
Arkansas ranks as the 2nd highest state in overall opioid prescribing rate among all the states in the nation, especially for older adults on Medicare. According to the Centers for Disease Control and Prevention (CDC), in 2019, the opioid prescribing rate for Arkansas was 102.1 opioid prescriptions for every 100 persons – nearly two-fold greater than the average U.S. rate.
Older Adults Should Know About Opioids and Falls
Every second in the U.S., an older adult suffers a fall, making it the main cause of injuries and deaths among older Americans. Falls can result in broken bones, other serious injuries, and loss of functional independence that may eventually lead to nursing home admissions. If you are age 60 or older and take opioid pain medications, you are more likely to fall than if you were taking a non-opioid pain medication such as acetaminophen (Tylenol).
Opioid side effects
If you are 60 or older, and take prescription opioid pain medications, you are at increased risk for having side effects. Some common side effects include sleepiness, constipation and nausea. More serious side effects include confusion, shallow breathing, slowed heart rate and loss of consciousness. It is important to ask your doctor about these possible side effects if you are given a prescription for opioids.
Prescription opioid pain medications may affect your heart.
Opioids are strong pain medications but are usually intended only for short-term use, such as after a surgery or other procedure. However, they often have unintended consequences for older adults, including problems with the heart:
- increased risk of having atrial fibrillation
- decreased heart rate and blood pressure
- impaired heart function and could cause heart failure
- increased risk of heart disease
Opioids and digestion
Opioids (narcotics) are a type of prescription pain medication used for severe pain relief. They should usually be used only for a short time. Long-term opioid use can lead to negative side effects. Opioids may slow down muscles in your gut making it difficult to have a bowel movement (constipation). They may also make it harder for your bladder muscles to pass urine or empty your bladder (urinary retention).
Opioids may make your pain worse
Opioids should only be used for a short time after a surgical procedure or serious injury. When used for a long time, opioids may not reduce your pain as well as they did at first. Instead, taking opioids for a long time may make you feel worse pain. This is called opioid-induced hyperalgesia (OIH).
What Older Adults Should Know About Non-Opioid Pain Medicines
Instead of relying on opioid pain medicines, there are non-opioids that may be as effective as opioids in managing chronic pain without the serious side effects. In addition, non-opioid medicines have fewer side effects. Examples of non-opioid medicines are:
- acetaminophen (Tylenol)
- acetylsalicylic acid (Aspirin)
- ibuprofen (Advil)
- naproxen (Aleve)
- diclofenac (Voltaren gel/cream)
These types of pain medicines are called non-steroidal anti-inflammatory drugs (NSAIDS) and may be bought over the counter. They work similarly to steroids without the side effects of steroids. There are stronger NSAIDS that must be prescribed by the doctor. NSAIDS are normally used for arthritis type pain, muscle aches, backaches, dental pain, and pain caused by gout or bursitis. They can also be used to reduce fever or relieve the minor aches caused by the common cold.
Before you buy any over the counter pain medicine – or other medicine, always check with your primary care doctor to see if these medicines are safe for you to take.
Integrative Therapies for Managing Chronic Pain
Integrative therapies are called complementary therapies when they are used with standard medicine such as combining a non-opioid pain medicine such as ibuprofen or acetaminophen with therapies such as massage therapy or ultrasound. Integrative therapies such as Tai Chi can also strengthen muscles and improve flexibility and posture; art and music therapy can help a person explore emotions and self-expression as well as reduce pain and also give a calming, relaxing effect.
Aromatherapy and mindfulness meditation has helped to ease chronic pain and discomforts of illness through distraction from the chronic pain. Mindfulness meditation is a form of concentration where a person observes the flow of inner thoughts, emotions and bodily sensations without judging them as good or bad. It is intended to reduce stress and decrease anxiety.
Integrative therapies do not have the side effects of medications. They may not work for everyone in the same manner. You may need to try more than one combination of therapies to determine what works best for you. They have the potential to help ease chronic non-cancer pain and other symptoms and to give you a better quality of life, better coping skills, and more options for controlling discomfort from chronic pain.
If you have chronic pain, ask your doctor to recommend an integrative therapy or therapies that may benefit you.
What is Naloxone?
Naloxone, also called Narcan, is a rescue drug that can reverse the effects of a bad reaction or accidental overdose from opioids. Naloxone is available in two forms, by injection and nasal spray. The spray is what is used most by the public. The naloxone flyer provides information on recognizing an opioid overdose and how naloxone is a rescue drug. Step-by-step instructions are included on how to give naloxone. If you have any questions about how to give naloxone, your local pharmacist will show you and a family member. Anyone who is taking prescription opioids should have a naloxone kit in the home. A prescription is not required, and Medicare covers most or all the cost.