Experts warn against long-term use of common pain pills

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The geriatrics society’s new guidelines say NSAIDs should be considered “rarely” in the population of frail elderly people, and used “with extreme caution” and then only in “highly selected individuals.” For those patients with moderate to severe pain that diminishes the quality of life, opiates may be considered, the guidelines suggest, after both the patient and caregiver are screened for prior substance abuse.

clipped from newoldage.blogs.nytimes.com Last week, an expert panel of American Geriatrics Society pretty much bumped all non-steroidal anti-inflammatory drugs, or NSAIDs, off the list of medicines recommended for adults ages 75 and older with chronic, persistent pain. Long-term use of drugs like ibuprofen, naproxen and high-dose aspirin is so dangerous, the panelists said, that elderly people who can’t get relief from alternatives like acetaminophen may be better off taking opiates, like codeine or even morphine. The risks from chronic use of NSAIDs are myriad. They can cause life-threatening ulcers and gastrointestinal bleeding, a side effect that occurs more frequently and with greater severity as people age. Some NSAIDs may increase the risk for heart attacks or strokes, and they don’t interact well with drugs used to treat heart failure. They can make high blood pressure worse, even uncontrollable, and impair kidney function. And the list of potentially hazardous interactions with other drugs is a long one, experts say.