Nursing home residents with an acute illness frequently experience increased pain after opioid use is interrupted, according to recently published findings.
Over a study period of approximately 11 months, 38% of acute illness episodes included a significant interruption in opioid administration, the investigators determined. A significant interruption was defined as dose reduction of more than 50% for at least one day.
Patients that experienced interruptions reported worse pain during follow-up periods than those without interruptions, the study authors found. Of those in the highest quartile of initial opioid dose, those with interruptions reported pain scores over time that were 0.22 points higher per day, compared with uninterrupted patients.
Symptoms of drug withdrawal were not found to be associated with opioid interruption, regardless of initial dose. The findings should put clinicians on alert as to the potential for interruptions and the resultant worsening of pain, the study authors concluded. They are affiliated with the Icahn School of Medicine at Mount Sinai in New York. Full findings appear in Clinical Therapeutics.
Long-term care professionals have spoken out against tightened restrictions on opioid painkillers, saying that it could make it more difficult to manage pain in a timely and effective fashion.
