Last week, the American Geriatrics Society (AGS) released revised guidelines for the management of chronic pain in the elderly, advising doctors to have their patients avoid nonsteroidal anti-inflammatory drugs (NSAIDs) and COX-2 inhibitors. According to these updated guidelines, it may be better for older adults with persistent pain to take an opioid painkiller, such as codeine, instead of over-the-counter products such as ibuprofen.

The revised guidelines primarily apply to people with chronic pain who are aged 75 or older. In these older patients, who often have multiple medical problems, the cardiovascular and gastrointestinal risks associated with NSAIDs usually outweigh the benefits. NSAIDs also have many drug-disease interactions that can be dangerous in the elderly.

The AGS’ recommendations are based on the most recent clinical trial data and clinical observations. In these revised guidelines, the expert panel recommends that NSAIDs and COX-2 inhibitors, such as Celebrex, be considered only rarely and with caution in a select group of patients. Although many physicians are hesitant to prescribe opioids for chronic pain, in part due to the potential risk for addiction, the AGS suggests that all older patients with moderate to severe pain or decreased quality of life due to pain should be considered for opioid therapy.

Source: Adapted from Reuters Health.