Managing Pain Medications in Older Adults

Managing pain medications for older adults can be difficult, especially when there are other medications, prescribers, and ailments to consider.


Communication is crucial
A lack of communication between prescribing physicians as well as patients can increase the risk of drug interactions, duplications, or under-treatment, as some people may assume pain is a part of getting older and not report it.

See Undertreatment of Pain in Older Adults

For example, a primary care doctor could prescribe an opioid for chronic headaches, while the person’s rheumatologist prescribes another type of opioid medication for back pain. Taking two opioids can increase the risk of falling and potentially fatal breathing problems due to both medications' sedating effects.

See Types of Opioids

Keeping a list of current medication can help eliminate confusion
Older adults may want to carry a list of current medications with the names of each drug and the dose, along with a list of drug allergies, to each medical appointment. The pharmacist can provide this list if all prescriptions are filled at the same pharmacy.

If more than one pharmacy is used, it is important to inform the pharmacists about medications filled from other sources, such as mail order or specialty pharmacies, as well as over-the-counter and herbal supplements.

It is difficult for anyone to remember the names and doses of multiple medications. Having this medication list can prevent confusion and is useful if there is an unexpected question from a health care professional or an emergency situation develops.

Medication Reviews

A medication review by the doctor or pharmacist can help determine whether all medications being taken are still needed.

Medication therapy management under Medicare
Under Medicare Part D, medication reviews are called Medication Therapy Management Programs (MTMP). Pharmacists or physicians meet with patients who bring all prescriptions, over-the-counter medications, and herbal products to the appointment.

Once all the medications and other products are known, the pharmacist or physician may suggest that a medication be discontinued or that a dose be adjusted. Determining the most beneficial dose of medication may help older adults maintain a high quality of life.

Older adults enrolled in Medicare Part D plans can contact his or her insurance company, doctor, or pharmacist to see if this program is available to them.

Guidance on stopping pain medication
Discontinuing any prescription pain medication should not be done before consulting a health care professional.

People who are on pain medications and wish to stop are advised to work with a doctor to gradually reduce the dose. Because the body becomes accustomed to pain medication, stopping all at once can cause uncomfortable withdrawal symptoms. Dizziness and diarrhea are common symptoms experienced when stopping these medications abruptly.


Non-pharmacological pain relief options
Certain treatment options can provide some pain relief without the risks and side effects of medication.

Alternatives to pain medication include:

  • Cognitive behavior therapy
  • Acupuncture
  • Physical therapy
  • Exercise

See Managing Chronic Pain Without Opioids

A doctor can provide information about medication-free approaches to pain management.

Efforts to critically assess all medications have the potential to improve health and save money.