Troubling Narcotic Use Found Among Older COPD Patients

Opioid use among older chronic obstructive pulmonary disease patients raises concerns

/ Author:  / Reviewed by: Beth Bolt, RPh

(RxWiki News) Opioids are commonly prescribed to patients with chronic obstructive pulmonary disease (COPD). But, for seniors with this condition, that may be a problem.

A new study from Canada found that older adults with COPD may be using opioids like morphine and codeine at significantly high rates. Because older adults are typically more sensitive to the side effects of these drugs, this finding has raised safety concerns among the medical community.

"The new use of opioids was remarkably high among adults with COPD living in the community," said lead study author Nicholas T. Vozoris, MD, a respirologist at St. Michael's Hospital in Ontario, in a press release. "The amount of opioid use is concerning given this is an older population, and older adults are more sensitive to narcotic side effects."

COPD is a chronic inflammatory lung disease that causes obstructed airflow and makes it difficult to breathe. Symptoms can include chronic cough, shortness of breath, wheezing and chest tightness.

According to Dr. Vozoris and team, opioids — such as codeine, oxycodone and morphine — are frequently prescribed to COPD patients to treat chronic muscle pain, breathlessness and insomnia. Side effects of opioid use can include falls, confusion, memory impairment and extreme fatigue. These effects may be especially strong in older adults.

For this study, Dr. Vozoris and team looked at the health records of more than 125,000 COPD patients over age 66 between 2003 and 2012. About 110,000 of these patients lived independently, while about 16,000 lived in long-term care facilities in Ontario.

During that time, 70 percent of those living independently were given a new opioid prescription. About 55 percent of those living in long-term care were given the same.

Both groups were also found to be using opioids excessively at significantly high rates. Many of these patients were given multiple opioid prescriptions, early refills and prescriptions that lasted more than 30 days.

Dr. Vozoris and team concluded that patients and doctors should be more careful about prescribing opioids for this population.

"This is a population that has chronic lung disease, and this drug class may also adversely affect breathing and lung health in people who already have chronically compromised lungs," Dr. Vozoris said.

This study was published Oct. 2 in the British Journal of Clinical Pharmacology.

The Canadian Thoracic Society funded this research. No conflicts of interest were disclosed.

Reviewed by: 
Review Date: 
October 5, 2015
Last Updated:
October 6, 2015