Opioids for the treatment of chronic non-cancer pain in older people

Abstract

Chronic pain occurs in 45-85% of the geriatric population and the need to treat chronic pain is growing substantially. Unfortunately, treatment for chronic pain is not always correctly targeted, which leads to a reduced quality of life, with decreased socialization, depression, sleep disturbances, cognitive impairment, disability and malnutrition. Considering these consequences, healthcare professionals should aim at improving the diagnosis and treatment of chronic pain in older persons. One of the most important limitations in achieving successful pain management is that older people are not aware that pain management options exist or medications for pain, such as opioids, have associated benefits and adverse effects. Importantly, opioids do not induce any organ failure and if adequately used at the right dosage may only present some predictable and preventable adverse effects. Treating and controlling chronic pain is essential in elderly patients in order to maintain a good quality of life and an active role in both the family and society. To date there are only a few randomized clinical trials testing opioid therapy in elderly patients, and the aim of the present review is to highlight the efficacy and tolerability of opioid use through a literature search strategy in elderly people with chronic non-cancer pain.