The United States is in the midst of an opioid epidemic that has lasted for years—and it’s become a concern in the senior housing industry.
To avoid opioid misuse in senior housing communities, it’s important to ensure pain management is a team effort and that opioids aren’t the first line of defense against chronic pain, experts agreed during a recent webinar hosted by Senior Housing News.
The U.S. senior population is far from immune to the opioid epidemic, Dr. Andrew Kolodny, co-director, opioid policy research and senior scientist at Brandeis University, said during the webinar.
For one thing, seniors “generally don’t have a hard time finding doctors who will continue them on opioids,” Kolodny said. At the same time, older adults’ opioid deaths are often underrepresented in data sets, as seniors’ deaths tend to be attributed to other underlying medical problems, rather than opioid misuse, he said.
Pharmacies can play a role in preventing opioid abuse in senior housing.
“Whenever we notice multiple opioid prescriptions coming from the same prescriber, multiple prescribers, or early refills, we contact prescribers and caregivers at long-term care facilities to express our concerns,” Mimoza Metarapi, clinical pharmacist at Medication Management Partners, noted during the webinar.
In senior living, recognizing and managing residents’ pain without relying on opioids is a group endeavor, according to Lore Brownson, senior vice president or quality services and chief compliance officer at Eden Prairie, Minnesota-based operator New Perspective Senior Living.
At New Perspective, for instance, just about everyone who’s inside a community—from unlicensed personnel to family members and visiting vendors—know that if they notice unusual behavior from a resident, they should relay that information to a nurse, who will check in to determine if pain management is needed.
“It’s a village approach to identifying changes,” Brownson explained.
If a resident does require pain management, the first step should never be giving the resident an opioid, according to Dr. Anthony Burgess, the chief medical officer at Kansas City, Missouri-based operator Tutera Senior Living & Healthcare.
“Opioids are not the end all, be all,” Burgess said. “They do not solve all problems.”
Instead, Burgess recommends starting a resident off with pain management techniques that are non-pharmacologic. These can include non-medical tactics such as meditation, music therapy, prayer, distraction and aromatherapy.
Burgess always, without exception, tries to manage a resident’s pain in non-pharmacologic ways before turning to medication.
“If we all did this, we’d have the [opioid] problem solved,” Burgess said.
All the while, he noted, pain management is usually a trial-and-error process.
“There is no one-size-fits-all, and no two people have the same pain,” he said.
Still, opioids have their time and place, the panelists agreed.
“These are very good medicines for treating pain at the end of life,” Kolodny noted.
Written by Mary Kate Nelson