If you are 60 or older, and take prescription opioid pain medications, you are at risk of having side effects. Some common side effects include sleepiness, constipation, and nausea. More serious side effects are confusion, shallow breathing, slowed heart rate, and loss of consciousness. Breathing can slow down to the point of coma and death. It is important to ask your doctor about these side effects if you are given a prescription for opioids. Let’s talk a little more about opioids and how they can affect your mental status.
Opioids are strong pain medications that can help if you have severe, short-term pain such as after surgery or other serious injuries. Even when taken as directed, these medications may cause confusion, sleepiness, and memory loss. Another word for confusion is delirium.
Confusion/Delirium is a sudden change in your mental status. Delirium usually develops rapidly over hours or days. Older persons with dementia can also become confused which can be part of the worsening of dementia and can occur slowly over months or years. Delirium can result with any opioid pain medication such as Tramadol, codeine, or morphine. Unrelieved severe pain can also cause delirium. Delirium may have other common underlying reasons such as pneumonia, urinary tract infections, other infections, or an imbalance of sodium, water, and other substances in the blood.
Delirium is potentially reversible, for example, by reducing the pain medication, treating the infection, and treating the sodium or water imbalance.
The liver and kidneys are responsible for clearing medications from the body. The function of the liver and kidneys is reduced with age, so opioids may stay in the body longer causing greater side effects.
There are other therapies and treatments that may work better than opioids to manage your chronic pain. Over-the-counter medicines such as acetaminophen, ibuprofen
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- Clinic, C. (n.d.). What is Delirium. https://myclevelandclinic.org/health/diseases/15252-delirium
- Gold, J. (2017, January 31). Prescribing Opioids To Seniors: It’s A Balancing Act. https://khn.org/news/prescribingopoids-to-seniors-its-a-balancing-act/
- HealthinAging.org. (n.d.). Delirium. https://www.healthinaging.org/a-ztopic/delirium
- Robinson, T. (n.d.). Prescription Opioids: What you Need to Know. https://www.cdc.gov.org/drugoverdose/pdf/ahapatient-opioid-factsheet-a.pdf
- Thomas A. Cavalieri, D. (2007, June). Managing Pain in Geriatric Patients. Journal of Osteopathic Association,