Experts Warn Against Long-Term Use of Common Pain Pills

May 6, 2009, 1:15 pm

New York Times

Aspirin and ibuprofen are staples in just about every medicine chest and first aid kit. They’re sold over the counter, and they’re not expensive. Most people don’t think twice about taking them.

But they should — especially if they’re elderly.

Last week, an expert panel of American Geriatrics Society pretty much bumped all non-steroidal anti-inflammatory drugs, or NSAIDs, off the list of medicines recommended for adults ages 75 and older with chronic, persistent pain. Long-term use of drugs like ibuprofen, naproxen and high-dose aspirin is so dangerous, the panelists said, that elderly people who can’t get relief from alternatives like acetaminophen may be better off taking opiates, like codeine or even morphine.

All this despite the fact that NSAIDs are known to be effective for chronic pain conditions that often plague older adults — and despite the fact that opiates can be addictive.

“We’ve come out a little strong at this point in time about the risks of NSAIDs in older people,” said Dr. Bruce Ferrell, chair of the panel that made the recommendations and a professor of geriatrics at the University of California, Los Angeles. “We hate to throw the baby out with the bathwater — they do work for some people — but it is fairly high risk when these drugs are given in moderate to high doses, especially if given over time.”

“It looks like patients would be safer on these opioids than on high doses of NSAIDs for long periods of time,” he said, adding that for most elderly, the risk of addiction appears to be low. “You don’t see people in this age group stealing a car to get their next dose.” More…