Lately there has been a great deal of news about the dangers of taking a narcotic pain reliever such as oxycodone or hydrocodone. According to CNN, deaths from opioid overdose have reached an all-time high. Most of these are deaths due to prescription drugs that are being used improperly.
But are there hazards from these drugs even when they are taken as directed? One reader reports her elderly mother’s difficulties with a narcotic pain reliever.
Would a Narcotic Pain Reliever Make an Older Person Unsteady?
Q. My 83-year-old mother recently fell on the ice and broke a rib. She was treated at urgent care and given a prescription for hydrocodone, but only a week’s worth.
When that ran out she went to her primary doctor who gave her a month’s worth. She only took one a day, even though the prescription was for as much as four pills per 24 hours.
One day in her apartment her legs just went out on her. She fell down and she didn’t have the ability to get back up. The next day I was concerned that she wasn’t calling me back, so I went to her place and found her like a beached whale on the ground.
The hydrocodone was so sedating for her that she could barely move. I had to call the paramedics to get her up from the floor, and they took her to the hospital.
Thank goodness the doctor there has seen many older patients because he said, “I am pretty sure the hydrocodone is the reason she fell down.” He told her the safest pain medicine for the elderly to take is Tylenol if the liver is working well.
What Pain Reliever Is Best for an Older Adult?
A. Narcotic pain relievers containing hydrocodone (Lorcet, Lortab, Norco, Vicodin) or oxycodone (OxyContin, Percocet, Tylox) can cause sedation, lightheadedness and dizziness. Such reactions are especially dangerous for older people, as they can lead to falls.
This can make pain management challenging. Some physicians prescribe tramadol as an alternative, but it too can trigger dizziness and drowsiness.
Acetaminophen Pros & Cons:
Acetaminophen (the active ingredient in Tylenol) doesn’t have these sedating effects, though liver function should be monitored to prevent harm. As people age, the liver becomes less efficient. If an older adult is using acetaminophen instead of a narcotic pain reliever, it is essential to monitor all medications. Acetaminophen is found in many drugs that are available by prescription as well as over the counter. If someone were taking multiple meds for pain, it could be alarmingly easy to overdose on acetaminophen.
Assessing the Risk of a Fall:
Since your mother fell twice (once on the ice and once in her home) in the last few weeks, it would be smart to make an assessment of her risk for future falls. As you know, a fall can be devastating for an older adult. A broken hip can curtail mobility for a long time. It might even lead to a blood clot that could become fatal if it traveled to the lungs or the brain.
Finding out how your mother’s apartment could be made safer, and what precautions may help her move around in the community with greater security would be well worth the effort.
