Prescribing Opioids to Older Adults: A Guide to Choosing and Switching Among Them

Marc Ginsburg, RN, MScN, NP; Shawna Silver, MD, PEng; Hershl Berman, MD, FRCPC


Geriatrics and Aging. 2009;12(1):48-52. 

In This Article


Choosing the right opioid for an older adult can be challenging for a number of reasons, including comorbidities, polypharmacy, physiological changes, and cognitive and communication challenges. For this reason, the safe and effective management of pain for older adults requires a careful, graduated, and systematic approach. Thorough cognitive assessment of patients' ability to comply with drug regimens is absolutely necessary. Upon switching opioids, it is important to ensure that patients are stabilized on immediate-release drugs prior to converting to their longer-acting formulations. Physicians must ensure that there will be no concomitant use of the previous drug. Continued monitoring is then essential to guard against side effects of the new medication and its metabolites.


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