Summer Fall 2017

15 Summer/Fall 2017 • Age-related fatigue, confusion, or other medical conditions may mask symptoms of misuse or addiction. Further exacerbating concerns for older adults using opioids is the increased risk for falls and bone fractures, a risk that is four to five times as likely for older patients using opioids than for those using non-opioid pain medication. 5 Opioid misuse also raises the risk for use and potential overdose of heroin, which if used by injection also brings concerns about the spread of HIV, Hepatitis C, or other infectious diseases. 1 Understanding Misuse, Abuse, and Dependency There are important distinctions to be made between opioid misuse, abuse, and physical dependency. Misuse For many seniors, increased drug tolerance over time may lead individuals to misuse their opioid prescription by increasing the dosage to achieve the same levels of pain relief. Abuse Using opioids for non-therapeutic purposes to induce feelings of euphoria is an abuse of the drug. continues  Physical Dependency Symptoms of withdrawal when stopping a medication, even under medically prescribed circumstances, are indications of physical dependence on the medication. These distinctions are significant to the prevention and treatment of opioid use disorder. The challenge for physicians is helping people effectively manage their pain in a way that gives them a measure of relief and offers continued independence and quality of life. 6, 7 The Hospital’s Role The American Hospital Association (AHA) has identified the following six roles for hospitals and health systems in addressing the opioid epidemic: 6 • Ensuring clinician education about and oversight of appropriate prescribing practices, including patent education • Offering treatment and referrals for patients with substance use disorder • Making sure that patients treated for substance use disorder are properly discharged