Do opioid concerns differ in the elderly?
In general, opioid tolerance is less likely to set in the elderly compared to younger people. As such, it is not unusual to observe elderly individuals with chronic pain on stable doses of opioids for years. While elder individuals with chronic pain often cite fear of addiction for refusing opioids, the risk for dependence or addiction appears to be smaller than the general population. Risk factors for dependence or addiction include history of previous personal or family history of substance abuse, or alcohol abuse as well as some personality and psychological disorders. While evidence supports the use of opioid analgesics in acute pain and end-of-life care, limited evidence exists in support of opioid use in chronic noncancer pain. In general, use of opioids in the management of chronic pain in the elderly should be undertaken with the same precautions as their use in the general population.