The Opioid Dilemma in an Aging, Ailing Population
A large retrospective study of over 800,000 Medicare beneficiaries with chronic pain reveals that opioid deprescribing rates are stubbornly low and similar across all patients, regardless of whether they have cirrhosis—a condition where opioids are considered particularly high-risk. While 37% of patients discontinued opioids within a year, the study found that deprescribing efforts slowed significantly after the onset of the COVID-19 pandemic. Factors like a history of falls, frailty, and the use of non-opioid painkillers were associated with a higher likelihood of dose reduction, suggesting clinicians may be responding to specific risk signals rather than broad guidelines.
Why it might matter to you:
This research highlights a critical gap between public health guidelines for opioid reduction and real-world clinical practice, especially for older adults with complex chronic conditions. For professionals focused on health behavior and chronic disease management, it underscores the need for more effective, patient-centered strategies for pain management that address the practical barriers to deprescribing. The findings suggest that successful intervention may require moving beyond blanket recommendations to target specific clinical vulnerabilities and systemic disruptions, like those caused by the pandemic.
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