CDC to Clinicians: Be Alert for Children With Poliolike Illness

Abstract

noncancerpain inolderadults,Solomonsaid. Heledastudythatusedhealthcareutilization dataforMedicarebeneficiariesstartingopioid therapy for noncancer pain to try to help answerthatquestion(SolomonDHetal.ArchInternMed. 2010;170[22]:1979-1986). Thestudy,publishedin2010,wasdevised “somewhat inresponsetotheAGSguideline,” Solomonsaid.Granted,hesaid, researchhad raised concerns about the safety of NSAIDs, butAGS“movedtoofar,perhaps, toembrace thepotential benefits of opioids.” Solomon’s study found that the ratesof adverseeventsvaried,dependingontheopioid and the duration of treatment. For example, the risk of cardiovascular events increased for codeine users after 180 days of use.And the risk of death fromall causes increasedafteronly30daysforusersofoxycodone or codeine. “This study’s findings do not agree with a commonly held belief that all opioids are associated with similar risk,” Solomon and his coauthors wrote. As the baby boomers age—the oldest arenowaged68years, the youngest nearly 50 years—overuse of opioids is expected to increase.With their historyof experimentationwithdrugs, thebabyboomersasagroup may be more likely to seek and abuse opioids thanmembersof their parents’ generation, Trevisan said. WestleyClark,MD, JD,MPH,directorof the Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services Administration, cited a 2006 report, coauthored by Compton, that projected the number of elderly individuals usingdrugs fornonmedical reasons in2020 (ColliverJDetal.AnnEpidemiol. 2006;16[4]: 257-265). By 2020, the nonmedical use of psychotherapeutic drugs, which includes opioid painkillers, was expected to reach 2.4%, nearly 2.7million, among thepopulation of US individuals 50 years or older, Compton and his coauthors wrote. That compares with 1.2%, or 911 000 people, in that age demographic in 2006. AlthoughtheAHRQstatisticalbriefcan’t prove thatopioidoveruseplayeda substantial role in the increase in US hospitalizations amongolder individuals, Clark said, he views the document as a “cautionary tale.” “I see it as opening the door for greater inquiries,” he said. “It is consistent with a number of other observations being made about the use of prescription opioids.”