Word: risk
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Which Painkiller Is Right? One opioid is associated with a significantly higher risk of overdose than other drugs: methadone, which is being used increasingly to treat chronic pain because it is cheaper and draws less scrutiny than other strong, long-acting opioids like Oxycontin...
Some of the overdose cases involved known drug misuse or suicide attempts, while others were due to patient error, but the study could not identify exactly what went wrong in all of the cases. Was it the high-prescribed dose alone, or were there other risk factors like illness, escalation of pain or undiagnosed addiction? While Von Korff and Volkow agree that prescription dose is a major contributor to overdose risk, they say better studies are needed to determine the precise causes and consequences. "One would hope that for a treatment regimen that millions of people are using...
...painkillers like ibuprofen and naproxen, and other non-steroidal anti-inflammatory drugs (NSAIDs) like Celebrex (celecoxib). Guidelines written and published by the American Geriatrics Society warned against using these drugs chronically and at moderate-to-high doses in patients age 75 or older with persistent pain. Citing the many risks of long-term NSAID use, including fatal ulcers and gastrointestinal bleeding, increased risk of heart attack and stroke and dangerous interactions with other drugs commonly prescribed to the elderly, the American Geriatrics Society suggested that seniors try acetaminophen instead. If that doesn't ease pain, older patients are advised...
...while the risk of opioid addiction in the elderly is low, there are other cautions. A 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...