Hooked

Narcotics use for chronic pain soars among seniors


Watchdog Reports

Gary Wickert had wanted to buy his wife a pill organizer.

Patricia, 71, was taking powerful narcotics to deal with chronic pain from a hysterectomy that didn't go as planned.

The drugs made her confused and disoriented. She napped frequently, and her memory faded. She started falling around their Muskego home and sometimes couldn't remember if she'd taken her pills.

She scoffed at the pill organizer, telling her husband, "I know what I'm doing."

About a year after her surgery, Gary left her asleep one night on the couch, not wanting to wake her. The next morning, he found her dead. Patricia's blood had toxic levels of hydrocodone, one of the most commonly prescribed narcotic drugs.

Years ago, Wickert might not have been prescribed the powerful narcotics for an extended period of time. Opioids were primarily for cancer pain and short-term relief immediately after surgery or an accident.

But increasingly, the drugs have been prescribed for chronic pain, an area where their safety and effectiveness is unproven, especially for older patients, a Journal Sentinel/MedPage Today investigation found.

Though a growing number of experts believe the drugs may do more harm than good, the country's aging population has become a prime market for the $9 billion-dollar-a-year industry.

Since 2007, top-selling opioids dispensed to people 60 years and older have increased 32%, according to a Journal Sentinel/MedPage Today analysis of prescription data from IMS Health, a health care information company. That's double the growth for prescriptions dispensed in the 40-to-59 age group.

The increase has been fueled in part by doctors and pain advocacy organizations that receive money from drug companies and make misleading claims about the safety and effectiveness of opioids, including that addiction is rare.

Since the late 1990s, drug makers have paid millions of dollars to influential researchers and organizations that advocate greater use of narcotic painkillers. National guidelines for treating chronic pain have become far friendlier toward the drugs. And doctors who receive money from drug makers have been at the center of changing those guidelines.

In 2009, the American Geriatrics Society joined others in advocating for greater opioid use to treat chronic pain in seniors, especially those 75 and older. The group's guidelines are a key reference for thousands of doctors on the front line of medicine.

The new guidelines recommended that over-the-counter pain relievers, such as ibuprofen and naproxen, be used rarely and that doctors instead consider prescribing opioids for all patients with moderate to severe pain. The panel members said they relied on research and their own experience in revising the guidelines, acknowledging "existing weak scientific evidence."

Among the 10 experts on the panel that made the recommendations, at least five had financial ties to opioid companies, as paid speakers, consultants or advisers at the time the guidelines were issued, the investigation found. A sixth, the panel chairman, was listed as a paid speaker for an opioid company a year later.

http://www.jsonline.com/watchdog/watchdogreports/narcotics-use-for-chronic-pain-soars-among-seniors-kg56kih-155555495.html?ipad=y