Opioid treatment safer, more effective at managing seniors' pain, guidelines say

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Treating seniors' chronic pain with non-steroidal anti-inflammatory drugs (NSAIDs) or cox-2 inhibitors is potentially more dangerous than opioid therapy, according to new pain management guidelines released by the American Geriatrics Society. The practice of using NSAIDs initially should be seriously reduced or eliminated, the guidelines say.

Common NSAIDs and cox-2 inhibitors, such as ibuprofen and aspirin, have long been used in the initial treatment of chronic pain among seniors. Opioids would be prescribed for pain management only after a lengthy course of this treatment. The new guidelines, which will be featured in the August, 2009, issue of the Journal of the American Geriatrics Society, suggest this is a risky strategy, due to potential cardiovascular and gastrointestinal complications for elderly patients. The risks outweigh the benefits, the guidelines say.

All older patients with chronic, persistent pain should be considered for opioid therapies, according to the AGS guidelines. The AGS suggests that new, more fully realized opioid treatments developed recently are likely to be safer over the long term. Guideline authors point out that persistent pain, though common, isn't a normal part of aging, and incorrect treatment can lead to falls, depression, anxiety and other negative health conditions.
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