Word: maye
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...understanding of how opioids work, and clarified their harms, the general question of safety remains complicated. Differences in the age and health of patients, their history of substance misuse, the nature of the pain and patients' sensitivity to certain drugs mean that a miracle drug for one person may be harmful to another. (See the top 10 medical breakthroughs...
...some cases, however, undertreated pain may contribute to a situation that looks like addiction; patients ask for higher and higher doses and appear to be drug-seeking, when in fact they are looking for effective pain relief...
Much of the blame may fall on the Food and Drug Administration (FDA) and physician ignorance. Until 2006, FDA guidelines, which have since been revised, suggested starting pain patients on 80 mg of methadone a day - a dose that could kill people who haven't developed tolerance to this class of medications. The current recommendations call for 30 mg to start...
...study published in January by Von Korff and colleagues linked high-dose opioid use to a doubling of the risk of broken bones in the elderly. "One-third of these were hip and pelvic fractures," Von Korff says. "These can really be debilitating." The authors speculate that the patients may have been prone to falls caused by dizziness or sedation, side effects of drug treatment that tend to occur early in a new drug regimen or when dosage changes...
...American Geriatrics Society says it took these considerations into account before writing its new guidelines. "There have been older studies that suggested that opioids may be associated with an increased risk for falls, and that's obviously a risk that physicians and patients should know about," says Ferrell...