Pain medication can be a complex issue for the elderly. Certain conditions, like dementia, can make it difficult for someone in your care to explain or describe their pain, and drug interactions can make narrowing down the cause of pain accurately a struggle. While there are some holistic ways to reduce pain – with massage, cold packs, and stretching – sometimes pain is not going to be properly managed with “home remedies”. You don’t want a senior in your care to suffer, but you want them to be safe.
Here are some considerations for the safe and effective care of a senior with chronic pain looking to resolve their discomfort with medications:
Drug interactions & comorbid conditions
While potential drug interactions can limit the spectrum of pain management medications offered to seniors suffering from chronic pain, just as often chronic pain is the result of drug interactions.
A common example of this involves Statins, the most prescribed drug in the world. Today, many seniors are taking one type of statin or another to lower cholesterol and reduce the risk of heart attack or stroke. Unfortunately, as many as one out of five people prescribed Statins report myopathy – chronic aches and soreness in their muscles. This is often a result of drug interactions with medication for comorbid conditions like diabetes, or hypertension.
A conversation with a health practitioner is crucial to rule out any drug interactions that may be causing pain and discomfort with any medication. Do not cease taking medication, like statins, without consulting a physician even if you are experiencing pain as a side effect.
Opioids & the risks
Opioids are very effective for treating pain quickly, even intense and chronic pain. The problem is that opioids are not a perfect solution – there are many serious side effects, like respiratory depression and long-term dependence or addiction. In fact, seniors represent the highest rate of accidental opioid poisoning in Canada, and a quarter of those hospitalized were taking their medication as directed by their doctor.
When caring for a senior with an opioid prescription, you can take steps to ensure they will be taking their medication properly. You can limit access to their prescription, you can counsel them to avoid drinking alcohol, and you can ensure with a physician there won’t be interactions with prescribed sedatives, like benzodiazepines.
Medical marijuana, THC & CBD
There is a lot of support in the medical research community and from physicians to support that cannabis (also known as weed, pot, marijuana, THC) and cannabidiol (CBD) can be potent pain relievers and is often as good as using opioids up to 50% of the time for chronic pain management.
Cannabis and CBD are non-habit forming and can be taken in many forms, like pills, tinctures or creams. Both can also be consumed in food or smoked.
Cannabis is known for the psychoactive properties that accompany THC, and can elevate mood, help with sleep, and cause a serious case of the giggles. CBD, while still remarkable in its ability to treat pain and emotional dysregulation, doesn’t get you high at all, because it does not contain THC.
Despite the range of claims and opinions about medical marijuana, it is not a magical cure-all, and in some cases may not be the ideal choice. For example, some users report that marijuana eases their anxiety, while others report that it exacerbates anxiety. Each senior is different, with different needs, so be sure to consult with a physician before starting a regiment of medical marijuana or CBD, and never halt the use of other prescribed medications in favour of cannabis without the express advice from a doctor.
The most important thing is to choose a pain management regiment with a physician that works while keeping current needs, prescriptions and long-term side effects in mind.