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Opioid use linked to ‘increased risk of fatal falls in older adults’

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Recent opioid use is associated with both an increased risk of falls in older adults and also an increased risk of death, warn Canadian researchers in the wake of a large study.

They said those prescribing opioids should be aware they were not only associated with an increased risk of falls but also, if the older patients receiving them did fall, a higher inpatient mortality rate.

“This study confirms an association between recent opioid use and fall-related injury”

Raoul Daoust

The researchers, from the Hôpital du Sacré-Cœur de Montréal, noted that the rate of opioid prescription for pain treatment has been increasing rapidly in North America in the past 20 years.

For example, between 2001 and 2010, the percentage of patients receiving an opioid prescription during an emergency department visit increased from 20.8% to 31%, a relative increase of 49%.

However, writing in the Canadian Medical Association Journal, they said the evidence for a link between opioid use and falls was previously viewed as “inconsistent”.

As a result, the analysed data on 67,929 patients aged 65 and older who were admitted for injury to one of 57 trauma centres in the province of Quebec.

The mean age of patients was 81 years, and 69% were women. Falls were the most common cause of injury and more than half had surgery for their injuries, with median hospital stays of 12 days.

The researchers also found that patients who had filled an opioid prescription during the preceding two weeks were 2.4 times more likely to have had a fall causing injury.

In addition, patients whose falls were linked to opioid use were also more likely to die during their hospital stay.

Filled prescriptions were for drugs including codeine, hydromorphone, meperidine, oxycodone, methadone, fentanyl, tramadol, tramacet, pentazocine and morphine.

The study authors, led by Dr Raoul Daoust, said: “This study confirms an association between recent opioid use and fall-related injury in a large trauma population of older adults.

“Physicians should be aware that prescribing opioids to older patients is not only associated with an increased risk of falls, but also, if these patients do fall, a higher in-hospital mortality rate,” they said.

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