After the Covid-19 pandemic, it is easy for anyone to forget that there are other large-scale epidemics in the world. Especially in the United States, although the public has almost forgotten the opioid crisis, it is still raging. According to CDCIn 2020, the number of deaths from drug overdose increased by 30.9% year-on-year, and a large part of it was 94,134 deaths caused by opioids.
The elderly are most likely to misuse and abuse opioids because they are more dependent on such drugs for treatment than young people.A sort of New Southern California University Survey One in ten adults was found to be at risk of opioid overdose. However, doctors play an important role in reducing the risk of opioid abuse in this population-with better intervention and tracking, most of the risks can be avoided.
As the elderly are particularly susceptible to the opioid epidemic, doctors can strengthen the successful record of opioid gradual reduction plans, and at the same time develop mitigation plans through strong personal relationships and micro and macro indicators.
Opioid reduction: risks and benefits
Although sometimes controversial, if the plan is fully planned and managed, the opioid gradual reduction plan is an effective resource to curb abuse.A study from the Scandinavian Journal of Pain Established The success rate of the overall implementation of the opioid reduction plan was 27.9%. Doctors must carefully review all the medications the patient is taking to develop an effective treatment plan, especially for the elderly who are more likely to take one or more painkillers. In any reduction plan, drug interactions can be a problem: for example, reduction of opioids and benzodiazepines must be done slowly and cautiously, otherwise the patient will be at risk of side effects such as discomfort, anxiety, and depression.Especially for elderly patients, follow Beer standardHowever, benzodiazepine may not be the best choice.
Improper drug discontinuation can have negative effects, especially in the elderly, which leads people to believe that gradually reducing drugs is ineffective and may lead to worse mental health outcomes.For example, a Learn It was found in JAMA that the gradual decrease in opioids may be related to the increased risk of overdose and mental health crisis in patients receiving long-term high-dose opioid therapy. However, comorbidities, previous opioid use, and low-efficiency follow-up of subjects may distort the results of the study, which may be the case in this study if analyzed more carefully. In fact, the reduction plan has been successfully applied to the entire medical profession, and many people advocate this method, as long as it is carefully managed and monitored.
Strategies to curb overuse
Doctors need to use innovative indicators to track patients’ opioid use, while using quantitative and qualitative methods to reduce abuse and overdose. Here are a few indicators that medical professionals can use to track and intervene in opioid use:
- Prescription Drug Monitoring Program (PDMP): In addition to Missouri, 49 states and the District of Columbia have implemented statewide PDMP provides easily accessible data resources to track the use of opioids and other controlled substances. PDMP provides online risk scores for each patient, which providers can use to monitor usage and potential abuse. If the risk score is high, the patient may be using high-dose opioids, or using a dangerous combination of drugs, or exhibiting abnormal behavior, indicating signs of potential abuse. By simplifying medical data, prescription input and providing these data throughout the patient’s medical treatment, doctors can better track the patient’s prescriptions. For the elderly, this is particularly critical, because many elderly patients only see a doctor or pharmacist continuously, and the prescription is automatically refilled-this is a high risk factor for abuse.
- Drug reconciliation: The provider did not do enough medication coordination, especially for elderly patients. The medicine cabinets of these patients are filled with bottles of past and present conditions. They may not understand what they are taking, which leads to unsafe opioid use. Doctors should often take time to check which drugs are in the elderly’s home and which drugs are being taken to reduce side effects and interfere with potential opioid abuse.
- Number of pills: Encourage patients to bring pills and count the number of pills to ensure they are taking the correct dose. Also check the supplement level: is the prescription supplemented every 30 or 90 days? Adding this check and balance to the pharmacy system can ensure that patients, especially the elderly, are not over-prescribed, and they do not need or get too many drugs that may be abused.
- Drug screening: As part of the initial and follow-up doctor visits, regular urine drug screening can effectively compare prescription drugs and drugs present in the body, which is a useful strategy for early detection of opioid abuse.
- consult: It is very important to educate people about the dangers of drugs and their use and unintentional overdose. Counseling is a key principle of an effective opioid tapering plan and a useful strategy to curb the abuse of older people, who often do not fully understand the complexity of their drugs or the potential for abuse of these drugs.
Opioids should not be used as the first-line treatment of painkillers-other drugs can even use over-the-counter drugs such as Tylenol, and they are a safer choice, especially for the elderly. When opioids are used, they need to be monitored very carefully at the level of prescription and settlement. Clinicians must be aware that coordination of care is one of the key factors in fighting the opioid epidemic and stopping the overuse of stronger and more dangerous drugs. Senior care providers who use these strategies and audits often ensure that patients understand all the benefits and risks of the medications they take. Medical staff are also at the forefront of the opioid epidemic, and spending a little more time reconciling drugs and asking questions can make a big difference in curbing overuse.
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