Analgesics in the elderly

Abstract

The aim of the study is to investigate whether elderly patients on long-term weak opioid analgesics could suffer the problems of tolerance and dependence. The prevalence of potential dependence amongst long-term users was assessed by a semi-structured questionnaire applying the Diagnostic Criteria for Research (DCR-10) criteria for Dependence Syndrome. The sample consisted of 25 randomly selected elderly patients drawn from four practices in North Cheshire, who had been on continuous repeat prescription of low potency opioid and compound analgesics containing them for a minimum of one year without apparent problem to themselves or their GPs. Approximately 2.8% of the elderly GP practice population were shown to be on opioid analgesics continuously for at a least one year. The study found that an estimated 40% of patients on low potency opioids fulfilled the DCR-10 criteria for Dependence Syndrome. It could be argued however that the finding may be, at least partly, the result of an undetermined specificity of DCR-10 as a screening tool. The finding, in such a small sample, is interesting but requires critical examination, as we believe it to be the first study of the possible effect of long-term use of opioid analgesics in primary care. The unexpectedly high prevalence highlights the need for further research in this area.