Chronic pain-characterized by aches, pains, and other afflictions that last for longer than 3 months or extend beyond the time needed for appropriate tissue healing-frequently mandates multiple medications such as nonopioid and opioid analgesics. 1 Long-term chronic pain in adults aged 65 years and above (hereafter referred to as older adults) is typically due to musculoskeletal disorders such as a degenerative spine, arthritis, neuropathic pain, ischemic pain, and pain due to cancer or cancer treatments. 2 Data from 2015-2018 showed that nearly 15.1% of adults over the age of 60 used one or more prescription pain medications, compared to just 5.4% of adults aged 20-39 in the United States (US). 3 This medication usage may present a number of health-related morbidities as a result of adverse drug reactions (ADRs), particularly due to kidney problems in older adults.Further, there exists a pressing concern regarding the potential for developing a substance use disorder (SUD). 4,5 This review will focus on strategies to address polypharmacy in older adults to minimize the risks of these two intersecting issues.
| CURRENT S TR ATEG IE S
| Comprehensive assessments and meaningful communicationThe first and most obvious approach to adequate management of patient pain is accurate diagnosis and effective communication about the patient's needs and goals in their care. Patients experiencing acute pain may not always need opioids and may only require nonopioid interventions in the form of physical or behavioral therapy. This may be coupled with patient and caregiver education. 6 Educating patients on their treatment options and the benefits, side effects, and addictive nature of opioid and nonopioid analgesics should be a standard practice to mitigate the risk of misuse. 7