Nursing home providers likely will have to perform a balancing act when using opioids to treat pain in residents with Alzheimer’s, as the medications offer both benefits and adverse effects, according to a Finnish researcher.
“On one hand, pain should be treated, but on the other hand, all drugs have adverse effects. Nonpharmacological methods should be preferred and also facilitated on a system level,” University of Eastern Finland researcher Aleksi Hamina said.
“If opioids are used, low initial doses and careful monitoring should follow. Research should focus on investigating the safest and most effective ways of treating pain in individuals with cognitive disorders,” he added.
In a recently published thesis, Hamina found that the use of opioid painkillers to alleviate pain for Alzheimer’s patients was associated with a decreased use of antipsychotics and benzodiazepine drugs. The findings could indicate that opioids provide better pain management, he noted.
However, the drugs still come with several health risks, including increased risk of pneumonia.
“Opioids weaken the cough reflex and increase sedation, possibly explaining the increased risk of pneumonia,” Hamina said.
A pair of July 2018 studies found that negative side effects, like confusion, more than tripled in frequency for dementia residents being treated with opioid-based painkillers.
“Long-term use of opioids can be problematic, as adverse effects may occur. In any case, regular assessment of pain and opioid use is important in all patients, those with and without cognitive disorders alike,” he added.
The research used data on more than 70,000 people diagnosed with Alzheimer’s in Finland. The full thesis has been published in the European Journal of Pain.
