Understanding opioid safety and overdose prevention for older adults

With increasing age, older adults are more likely to encounter health conditions and injuries that require opioid therapy for pain relief. This reality means that opioid overdoses are a concern for older adults as well as for their family members and other caregivers.

A new Gerontological Society of America report, "Staying Safe with Opioids at Home," describes questions about pain management and opioid reversal for older adults and their caregivers and presents a decision tree to guide their actions.

"Caregivers should take the steps described in this guide if someone has signs and symptoms that indicate an apparent overdose," the report states. "To be prepared for a possible opioid overdose, naloxone should always be in the home if opioids are present or if any family members bring in opioids that were not purchased at a pharmacy."

Organized into four key questions, the report covers monitoring, storage, and discarding opioids; the most common and most serious side effects of opioids; prior use of illicit drugs and possible use of recreational drugs during opioid therapy; and what to do if family members and other caregivers are concerned that an older adult has overdosed on opioids.

Among the key points emphasized in the report:

• Naloxone (also commonly known as the brand name Narcan) is a medication that can be used to restore breathing in people who have overdosed on opioids. When opioids are prescribed, the health care professional should also prescribe naloxone. Consumers can also purchase naloxone without a prescription.
• To be prepared for a possible opioid overdose, naloxone should always be in the home if opioids are present or if any family members bring in opioids that were not purchased at a pharmacy.
• Naloxone works by temporarily reversing the effects of opioids like heroin, fentanyl, and prescription painkillers.
• When opioids are present in the home, they must be stored properly - safely away from pets, children, and drug-seeking adolescents and adults.
• If someone appears to be unconscious and is not breathing normally, the life-saving medication naloxone should be administered.
• Sedation and opioid overdoses are difficult to tell apart. When in doubt, act.
• Even if a person has been safely taking opioids for a while, overdoses can occur.
• Naloxone will not hurt a person even if it turns out there wasn't an overdose.
• "Lay, spray, and stay" are the basic steps in naloxone rescue.
• It is essential to act quickly, as minutes matter in opioid overdoses. Death or permanent brain damage can occur quickly in someone who is in respiratory failure.
• A person who receives naloxone needs to be evaluated by medical professionals even when naloxone works initially. Additional naloxone doses may be needed.