Misuse Of Analgesics Research Articles

Decreasing Incident Opioid Use Disorder, Especially Adolescent and Young Adult.

Opioid prescription policies may reduce availability of prescription opioids and decrease initiation of opioid analgesic misuse and possible opioid use disorder (OUD). OUD prevalence may have decreased in recent years, but there are few studies on trends of OUD incidence. The objective of this study was to examine OUD incidence rates to detect population changes overall and within demographic subgroups over time. In 2023, a longitudinal analysis of incident OUD diagnoses was conducted after implementation of Vermont's July 2017 policy limiting opioid analgesic prescriptions for acute pain. Included were individuals 16+ years with medical claims in Vermont's all-payer claims database between July 1, 2017 and December 31, 2021. Multiple Poisson regression models assessed changes in OUD incidence rates per month overall, controlling for age, sex, rurality, and insurance type, and separately, testing age, rurality, and insurance as moderators. Among 537,707 individuals, there was a 0.8% decrease per month in the OUD incidence rate (95% CI: 0.991, 0.993) from July 2017 through December 2021. Age moderated the association between OUD incidence and time, with the largest decrease per month (1.6%) among 16-29 year-olds (95% CI: 0.981, 0.986). There were smaller decreases in OUD incidence rate per month among 30-44 year-olds (0.6%), 45-59 year-olds (0.5%), and 60+ year-olds (0.6%). This study found that the OUD incidence rate in Vermont decreased overall between July 2017 (policy start limiting opioid analgesic prescriptions) - December 2021, including during the COVID-19 pandemic, with the most pronounced decrease among adolescents and young adults.

Monitoring opioid analgesic misuse, abuse and dependence: What to the data from addictovigilance tell us about the situation in France?

Monitoring opioid analgesic misuse, abuse and dependence: What to the data from addictovigilance tell us about the situation in France?

The misuse of analgesics and nonsteroidal anti-inflammatories in runners

The misuse of analgesics and nonsteroidal anti-inflammatories in runners

Biasing Gβγ Downstream Signaling with Gallein Inhibits Development of Morphine Tolerance and Potentiates Morphine-Induced Nociception in a Tolerant State.

Opioid analgesics are widely used as a treatment option for pain management and relief. However, the misuse of opioid analgesics has contributed to the current opioid epidemic in the United States. Prescribed opioids such as morphine, codeine, oxycodone, and fentanyl are mu-opioid receptor (MOR) agonists primarily used in the clinic to treat pain or during medical procedures, but development of tolerance limits their utility for treatment of chronic pain. Here we explored the effects of biasing Gβγ signaling on tolerance development after chronic morphine treatment in vivo. We hypothesized that biasing Gβγ signaling with gallein could prevent activation of regulatory signaling pathways that result in tolerance to antinociceptive effects of MOR agonists. Gallein has been shown to bind to Gβγ and inhibit interactions of Gβγ with phospholipase-Cβ3 (PLCβ3) or G-protein-coupled receptor kinase 2 (GRK2) but not G-protein inwardly rectifying potassium (GIRK) channels. In mice, morphine-induced antinociception was evaluated in the 55°C warm water tail withdrawal assay. We used two paradigms for gallein treatment: administration during and after three times-daily morphine administration. Our results show that gallein cotreatment during repeated administration of morphine decreased opioid tolerance development and that gallein treatment in an opioid-tolerant state enhanced the potency of morphine. Mechanistically, our data suggest that PLCβ3 is necessary for potentiating effects of gallein in an opioid-tolerant state but not in preventing the development of tolerance. These studies demonstrate that small molecules that target Gβγ signaling could reduce the need for large doses of opioid analgesics to treat pain by producing an opioid-sparing effect. SIGNIFICANCE STATEMENT: Biasing Gβγ signaling prevents tolerance to repeated morphine administration in vivo and potentiates the antinociceptive effects of morphine in an opioid-tolerant state. Mechanistically, phospholipase-Cβ is necessary for potentiating effects of gallein in an opioid-tolerant state but not in preventing the development of tolerance. This study identifies a novel treatment strategy to decrease the development of tolerance to the analgesic effects of mu-opioid receptor agonists, which are necessary to improve pain treatment and decrease the incidence of opioid use disorder.

Chronic pain healthcare workers’ challenges in pain management and receptiveness towards VR as an adjunct management tool: a qualitative study

Abstract Background Chronic pain is often a debilitating condition that affects individuals physically and mentally. Reliance on pharmacotherapy for pain management comes with risks of analgesic misuse and dependence. Hence, non-pharmacologic treatment plays a crucial role in pain management. Virtual reality is a novel method in chronic pain management. However, there is little understanding about healthcare providers’ perspectives on the use of virtual reality technology in managing chronic pain. This study aims to explore the current management challenges faced by chronic pain healthcare providers and their perspectives on using virtual reality as adjunctive therapy in managing chronic pain. Method Individual semi-structured interviews were conducted among all chronic pain healthcare providers in a tertiary hospital. The interviews were analysed using qualitative thematic analysis. Results Eight chronic pain healthcare providers participated in this study. Financial issues were cited as one of the biggest barriers to utilisation of non-pharmacological treatment. Participants highlighted the importance of psychosocial support from family and healthcare providers. Challenges identified included absence of patient engagement and lack of awareness about pain management among healthcare providers as well as the lack of an integrated multidisciplinary approach in our healthcare system. Participants were receptive towards the use of virtual reality in chronic pain management and offered ample opinions and suggestions for its application in chronic pain management. Conclusions A multilevel, multifaceted approach is needed to improve chronic pain management. Virtual reality technology could be considered as an adjunct therapy to address some of the challenges and limitations identified in this study.

Childhood trauma and the use of opioids and other prescription analgesics in adolescence and young adulthood: The HUNT Study.

Opioid and nonopioid analgesics are commonly prescribed to young people to alleviate pain. Even short-term prescriptions increase the risk of persistent use and future misuse of potent analgesics, such as opioids. Childhood trauma exposure has been found to be related to pain conditions and to using more prescription analgesics. This large, prospective cohort study aimed to investigate the association of a broad range of childhood trauma exposures with prescription rates for opioid and nonopioid analgesics in adolescence and young adulthood. Self-reported data on childhood trauma exposures from adolescents (aged 13-19 years) who participated in the Young-HUNT3 Study (2006-2008, n = 8199) were linked to data from the Norwegian Prescription Database (NorPD, 2004-2021). We found that exposure to childhood trauma was consistently associated with higher prescription rates for opioids throughout adolescence and young adulthood. The highest incidence rate ratio (IRR) in adolescence was observed for sexual abuse (IRR 1.63, confidence interval [CI] 1.19-2.23). In young adulthood, the highest IRR was observed for physical violence (2.66, CI 2.27-3.12). The same overall pattern was observed for nonopioid analgesics. The more frequent prescriptions of opioid and nonopioid analgesics to participants exposed to childhood trauma suggests a higher symptom load of pain causing them to seek professional help with pain relief. Receiving potent analgesics is not without risk, and the likelihood of misuse may be elevated among trauma-exposed individuals. A trauma-informed approach to pain could be vital for guiding clinicians to the most effective and least harmful treatment for each patient.

The Impact of Enhanced Recovery After Surgery Protocol Implementation on Postoperative Pain Management in the Era of Opioid Crisis: The Post- Chemotherapy Open RPLND Experience.

Enhanced Recovery After Surgery (ERAS) protocols have been proven to optimize postoperative outcomes; however, misuse of opioid analgesics can still hinder postoperative recovery due to related side effects and potential complications. To determine if the implementation of ERAS protocol in post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) patients could help with reducing postoperative pain and opioid use. A case-control study of consecutive testicular cancer patients with indications for PCRLPND, who were offered Conventional Post-operative Management (CPM) or ERAS protocol. Outcomes of interest included Visual Analogue Scale (VAS)-assessed pain level at postoperative days 3, 7, and 30, and Morphine-Equivalent Doses (MEDs)/postoperative day. Intraoperative parameters and postoperative complications were recorded. Parametric and non-parametric tests were used for statistical analysis. In total, 100 opioid-naïve PC-RPLND patients were studied. CPM and ERAS groups (36 and 64 patients, respectively) had similar demographic and baseline clinical characteristics). ERAS group patients had significantly lower blood loss (p = 0.005), blood transfusion rate (p < 0.001), and duration of the procedure (p < 0.001). Post-operative complications were comparable between groups. Nausea and bowel disorders were numerically but not statistically more frequent in the CPM group. ERAS patients had shorter mean hospital stay (5.3 ± 1.4 vs. 7.4 ± 1.6 days, p < 0.001), lower daily MEDs (4.73 ± 2.63 vs. 7.04 ± 2.29, p < 0.001), and lower VAS scores on post-operative day 7 (3.89 ± 1.07 vs. 4.67 ± 1.17, p = 0.001). Post-operative pain was similar between groups on post-operative days 3 and 30. Systematic implementation of ERAS protocol after PC-RPLND improves pain management, optimizes patient recovery, and prevents over-prescription of opioid analgesics.

Oxycodone withdrawal induces HDAC1/HDAC2-dependent transcriptional maladaptations in the reward pathway in a mouse model of peripheral nerve injury.

The development of physical dependence and addiction disorders due to misuse of opioid analgesics is a major concern with pain therapeutics. We developed a mouse model of oxycodone exposure and subsequent withdrawal in the presence or absence of chronic neuropathic pain. Oxycodone withdrawal alone triggered robust gene expression adaptations in the nucleus accumbens, medial prefrontal cortex and ventral tegmental area, with numerous genes and pathways selectively affected by oxycodone withdrawal in mice with peripheral nerve injury. Pathway analysis predicted that histone deacetylase (HDAC) 1 is a top upstream regulator in opioid withdrawal in nucleus accumbens and medial prefrontal cortex. The novel HDAC1/HDAC2 inhibitor, Regenacy Brain Class I HDAC Inhibitor (RBC1HI), attenuated behavioral manifestations of oxycodone withdrawal, especially in mice with neuropathic pain. These findings suggest that inhibition of HDAC1/HDAC2 may provide an avenue for patients with chronic pain who are dependent on opioids to transition to non-opioid analgesics.

A review on the impact of analgesic use during pregnancy on stillbirth

Stillbirth is a tragic complication of the pregnancy which is associated with emotional, social and economic disturbances. Stillbirth can be a result of advanced maternal age, smoking, obesity, comorbid conditions, poor economic status, drug use during pregnancy, etc. Though evidences suggest a number of factors contributing to stillbirth, use of analgesics adds an extra burden for the occurrence of stillbirth. Every drug has its own set of pros and cons, which may directly or indirectly affect the foetal health. Drug exposure was associated with the two-fold increased risk of stillbirth in pregnancy. Due to lack of significant evidence suggesting the occurrence of stillbirth which is a result of analgesic use, control over the use of analgesics during pregnancy is not well established. Hence, in the current literature review, the risk of analgesic-induced stillbirth is highlighted. The misuse of analgesics as over-the-counter medicines is widely known. Painkillers are often used to self-medicate without the supervision of a medical practitioner. Some of these drugs tend to cross the placental barrier and can have hazardous effects on foetus. Many circumstances might drive a pregnant woman to use analgesics which includes pain associated with the adaptation of mother’s body to the change during pregnancy. Due to ease of access and lack of knowledge about foetal risk, analgesics are consumed irrationally leading to pregnancy-related complications such as stillbirth.

Self-reported reasons for opioid and analgesic misuse among participants without cancer in the United States

ABSTRACT Background This study examined opioid and analgesic misuse, and associated reasons for misuse, among participants without cancer in the United States. Methods We extracted data from three distinct waves of the National Survey on Drug Use and Health (NSDUH, 2017–2019). Using weighted multivariable logistic regression models, we examined the associations between misuse and its reasons. Results Among individuals without cancer who misused pain relievers, the top three reasons for misuse were to relieve physical pain (62.6%), to get high (29.2%), or to relax (28.9%). For compound analgesics, the top three reasons for misuse were similar: relieving physical pain (67.9%), getting high (22.1%), and relaxation (25.6%). Compared to participants who misused opioids, respondents using compound analgesics and other pain relievers had lowers odds of using pain relievers for getting high (all p < .05). Conclusion Understanding the underlying reasons for opioid and analgesic misuse can inform development of public health policy and help in determining best practices for prescription and monitoring programs.

Structure-Based Design of Glycosylated Oxytocin Analogues with Improved Selectivity and Antinociceptive Activity.

Acute and chronic pain is often treated with opioids despite the negative side effects of constipation, physical dependence, respiratory depression, and overdose. The misuse of opioid analgesics has given rise to the opioid crisis/epidemic, and alternate nonaddictive analgesics are urgently needed. Oxytocin, a pituitary hormone, is an alternative to the small molecule treatments available and has been used as an analgesic as well as for the treatment and prevention of opioid use disorder (OUD). Clinical implementation is limited by its poor pharmacokinetic profile, a result of the labile disulfide bond between two cysteine residues in the native sequence. Stable brain penetrant oxytocin analogues have been synthesized by replacement of the disulfide bond with a stable lactam and glycosidation of the C-terminus. These analogues show exquisite selectivity for the oxytocin receptor and potent in vivo antinociception in mice following peripheral (i.v.) administration, supporting further study of their clinical potential.

DRUG MISUSE AND SELF-MEDICATION AMONG PHARMACY STUDENTS IN JORDAN

Aim: To estimate risks and prevalence of self-medication and potential abuse risk among pharmacy students in Jordanian Universities. Materials and Methods: A cross-sectional study design was conducted with 450 students, selected using multistage sampling methods, from seven different universities. Data was collected by self-administrated questionnaires covering demographic and academic information, health-related information, use of self-medication, and pattern of self-medication among pharmacy students. Results: Out of 394 students who answer the questions, 76.9% reported that they had usually treated themselves in case of simple cases without physician or pharmacist consultation. Most commonly used drugs among the surveyed students were Paracetamol 60%, multivitamins supplement 74.25%, and herbal products 37.2%, combination of NSAIDs and Paracetamol 20.6%, and laxatives 19.4%. Cold and flu 25.5%, headache 22.3%, abdominal pain 7.9%, gastric pain 7.9%, cold and flu, headache, abdominal pain, and gastric pain 14.9% were the main conditions which contribute to self-medication practice. It was also found that Pharmacy students were over-confident with the type of cases they could treat without referral to a specialist physician, despite knowing that some of the symptoms may be due to serious health problems. Misuse of analgesics and laxatives was clear, and there was a weakness in knowledge of the indications for the use of the most common drug. Conclusions: The prevalence of self-medication among pharmacy students in Jordan is high, and medical teaching institutions need to educate students about the proper use of medicines. Strict legislation and more education on self-medication are necessary for effective use of medicines.

PO243 / #898 USE OF FLUOROSCOPY-GUIDED BILATERAL SPLANCHNIC NERVE BLOCK AS AN OPTIMAL ALTERNATIVE TO CELIAC PLEXUS BLOCK FOR MANAGEMENT OF CHRONIC INTRACTABLE PAIN SECONDARY TO CHRONIC PANCREATITIS: E-POSTER VIEWING

The pain associated with chronic pancreatitis (CP) can be debilitating, often leading to excessive use and misuse of narcotic analgesics. Splanchnic nerve block is a technique aimed at interrupting the neural conduction causing abdominal pain [1]. Previous studies focused, predominantly, on using this technique for treating pain associated with upper gastrointestinal malignancies. However, it can provide great relief for those with persistent pain from CP [2]. We describe a case report for management of intractable pain from CP with fluoroscopic guided bilateral splanchnic nerve block in a young female with opioid-use disorder (OUD) and status post distal pancreatectomy.

Printed graphene-based electrochemical sensor with integrated paper microfluidics for rapid lidocaine detection in blood

Topical lidocaine patches are commonly used to relieve pain and suffering in various clinical and household settings. Despite its extensive use, excessive skin absorption during numbing or pain reduction procedures can cause systemic toxicity, which can lead to life-threatening conditions. Rapid and reliable monitoring of escalating levels of lidocaine in the blood could help management/prevention of lidocaine overdose and its associated complications. To address this need, here we have developed a disposable point-of-care (POC) diagnostic platform composed of an integrated graphene-based electrochemical sensor with paper-based microfluidics for rapid detection of lidocaine levels in serum and blood samples. The fabrication process takes advantage of advanced, scalable manufacturing techniques, including printing, laser processing, and nondestructive near infrared (NIR) drying. The sensitivity tests of the platform revealed a sensitivity of ∼0.2 μA μM−1 towards lidocaine concentrations in the clinically relevant range (1–100 μM) in both complex matrix fluids of serum and blood with high cross specificity in the presence of the interfering analytes. This proof-of-concept platform could be regarded as the first step toward the development of low-cost and translational POC devices that could help in better pain management and reduce potential side effects or misuse of analgesics.

Knowledge and Risk Perceptions of Chronic Kidney Disease Risk Factors among Women of Childbearing Age in Lagos State, Nigeria: From a Health Demography Approach.

Background Kidney disease (KD), also known as chronic kidney disease (CKD), is a long-term underrecognized public health concern and one of the eight leading causes of death in women. Despite that, little is known about women's knowledge, perceived risk, and perceptions of CKD risk factors. In this study, we assessed knowledge, perceived risk, and perceptions of CKD risk factors among women of childbearing age in Lagos State, Nigeria. Methods Administering a pretested and structured questionnaire among 825 women aged 15–49 years, we conducted a cross-sectional descriptive study to evaluate knowledge, self-reported CKD risk factors, and risk perception among women of childbearing age in urban and semiurban communities in Lagos State, Nigeria. We used descriptive (mean, frequencies, and percentages) and bivariate statistics (chi-square) to assess sociodemographic factors influencing knowledge and perceptions of CKD risk factors. Binary and multinomial logistic regressions were further employed to assess risk perceptions of CKD factors associated with knowledge. Results Five hundred and forty (65.5%) out of 825 women reported being knowledgeable of CKD risk factors with majority of the younger adult women (15–29 years) having good knowledge than other age cohorts, with a mean age of 33.5 ± 11.5 years. The women's knowledge of CKD was found to be significantly associated with independent and dependent risk factors (p < 0.05). The major self-reported independent CKD risk factors were misuse of analgesics (NSAIDs) (OR = 1.20; p < 0.05), herbal drinks (OR = 2.30; p < 0.05), and herbal supplements (OR = 1.37; p < 0.05), while self-reported dependent CKD risk factors were hypertension (OR = 2.14; p < 0.05), family history of KD ailments (OR = 1.30; p < 0.05), and high cholesterol (OR = 1.44; p < 0.05). Similarly, majority of the women had low perceived CKD risk (54.8%), while women with CKD risk factors (independent and dependent) view themselves at decreased perceived risk for the disease compared to those who are not associated with CKD risk factors (p < 0.05). Also, findings revealed that women had poor perception of risk factors associated with CKD. The multivariate analysis of perceived risk showed that demographic factors (younger aged adults, high education, and high income), independent risk factors of CKD (misuse of NASAIDs and excessive use of herbal drink and herbal supplement), and dependent risk factors (hypertension and family history of KD ailments) were significantly associated with knowledge of CKD (p < 0.05). Conclusion Our study reveals high knowledge of CKD risk factors but low perceived risk and poor perception of the link between CKD risk factors and its ailments. Given this, there is a call for urgent measures to create sensitization and provide public CKD behavioural health interventions as well as easy communication strategies for women to secure better access to awareness intervention programmes and healthcare services.

A novel HDAC1/2 inhibitor alleviates physical and emotional symptoms associated with spontaneous oxycodone withdrawal in neuropathic pain mice

The development of physical dependence and addiction disorders due to misuse of opioid analgesics is a major concern with pain therapeutics. In this study, we developed a mouse model of oxycodone misuse in order to gain insight into genes and molecular pathways in reward‐related brain regions that are affected by prolonged exposure to oxycodone and subsequent withdrawal in the presence or absence of chronic neuropathic pain. RNA‐sequencing (RNA‐seq) and bioinformatic analyses revealed that oxycodone withdrawal alone triggers robust gene expression adaptations in the nucleus accumbens (NAc), medial prefrontal cortex (mPFC), and ventral tegmental area (VTA), with numerous genes and pathways selectively affected by oxycodone withdrawal under peripheral nerve injury states. Our pathway analysis predicted that histone deacetylase 1 (HDAC1), an epigenetic modifier with a prominent role in striatal plasticity, is a top upstream regulator in opioid withdrawal in both the NAc and mPFC. Indeed, treatment with the novel HDAC1/2 inhibitor RCY1305 attenuated behavioral manifestations of oxycodone withdrawal, with the drug being more efficacious under states of neuropathic pain. Our studies also suggest that RCY1305 treated mice did not develop conditional place preference. Since RCY1305 displays antiallodynic actions with no rewarding effects in models of neuropathic pain, inhibition of HDAC1/2 may provide an avenue for chronic pain patients dependent on opioids to transition to non‐opioid analgesics. Overall, our study highlights transcriptomic events in components of the reward circuitry associated with oxycodone withdrawal under pain‐naïve and prolonged neuropathic pain states, thereby providing information on possible new targets for the treatment of physical dependence to opioids and transitioning individuals to non‐opioid medications for chronic pain management.

Opioid use disorder in anaesthesia and intensive care: Prevention, diagnosis and management.

Opioid misuse is common, as is opioid agonist treatment of opioid dependence. Almost 3% of Australians and over 3.5% of those living in New Zealand report misuse of analgesics. Over 50,000 Australians receive opioid agonist treatment with methadone or buprenorphine for management of severe opioid use disorder.The perioperative period is an opportunity to identify pre-existing opioid misuse, and to introduce interventions to reduce the risk of development of opioid use disorder. Challenges of acute perioperative pain management or intensive care management of patients receiving opioid agonist treatment include opioid tolerance and ongoing prescribing of methadone or buprenorphine. There has been some ambiguity about the optimal perioperative management of buprenorphine, a partial agonist at the mu receptor.In this article, a framework to identify emerging opioid misuse problems, identify risk of overdose and to manage the opioid-dependent patient on opioid agonist treatment perioperatively or in the intensive care unit is provided. Diagnostic criteria and risk stratification criteria are presented. Management strategies include trauma-informed care, care planning and care coordination with community practitioners and opioid agonist treatment providers. Continuing methadone or buprenorphine perioperatively with additional opioid and non-opioid analgesia is generally recommended. Increased opioid agonist treatment doses may be required on discharge. An algorithm for decisions about opioid agonist treatment management in the intensive care unit based on the risks of opioid withdrawal and toxicity is considered. Strategies for managing the opioid-dependent patient who is not in treatment are also discussed.

Enhancing risk perception may be insufficient to curtail prescription opioid use and misuse among youth after surgery: A randomized controlled trial

ObjectiveThis randomized controlled trial examined whether an interactive, risk-focused educational program was associated with higher risk perceptions and decreased prescription opioid use/misuse among emerging adults. Methods503 participants aged 15–24 years scheduled for ambulatory surgery were randomized to routine prescription education with or without our Scenario-Tailored Opioid Messaging Program (STOMP) provided prior to receipt of a prescribed opioid. Surveys were completed preoperatively, and at days 7&14, months 1&3 postoperatively. Outcomes included analgesic risk perceptions, opioid use, and misuse intentions/behavior. ResultsCompared to Controls, STOMP was associated with stable but higher risk perceptions on day 14 (β = 1.76 [95% CI 0.53, 2.99], p = .005) and month 3 (β = 2.13 [95% CI 0.86, 3.40], p = .001). There was no effect of STOMP or analgesic misuse risk perceptions on days of opioid use or subsequent misuse intentions/behavior. The degree to which participants valued pain relief over analgesic risk (trade-off preference) was, however, associated with prolonged postoperative opioid use and later misuse. ConclusionEducation emphasizing the risks of opioids was insufficient in reducing opioid use and misuse in youth who were prescribed these analgesics for acute pain relief. Practice implicationsEducation may need to better address analgesic expectations to shorten opioid use and mitigate misuse.

The opioid crisis: evaluating the safety and efficacy of opioid analgesia in the management of acute post-operative dental pain

The use and misuse of opioid analgesics have been highlighted in recent years. This review assesses dental opioid use, the effectiveness of opioid-containing analgesics versus non-opioid alternatives and the implications for post-operative pain management strategies in the dental practice. Guidelines for the management of acute post-operative dental pain differ from country to country. The UK has a low dental opioid use rate when compared to the US. The combination of paracetamol and ibuprofen has similar, if not better, analgesic properties compared to opioid-containing alternatives, with fewer adverse effects. CPD/Clinical Relevance: Non-opioid analgesics are both a safe and effective alternative to opioid analgesics in the management of post-operative dental pain.

Clinical consequences of abuse and misuse of hypnotics and analgesics in geriatric population

Insomnia and pain coexist with chronic diseases, especially in the elderly, who are therefore the largest group taking hypnotics and analgesics. For this reason, seniors are at high risk of abusing these medications, leading to dangerous and unpredictable clinical outcomes. The article provides a literature review using the Pubmed, Medline, Embase and Google Scholar databases. The articles were analysed using the following keywords: drug abuse, sleeping pills, painkillers, benzodiazepines, opioids. The article presents the characteristics of medical substances belonging to sleeping pills and painkillers, taking into account the consequences of their misuse. Hypnotics and pain relievers, especially benzodiazepines and opioids, are the most abused drug classes in the elderly. In the case of hypnotics, apart from benzodiazepines, these are zolpidem and zopiclone or trazodone, and in the case of analgesics, codeine, tramadol, morphine or oxycodone and also paracetamol and NSAIDs. The problem of abuse and misuse of hypnotics and analgesics in the geriatric population is still growing and therefore more and more attention should be paid to this problem. Although this type of treatment is important to maintain a good quality of life for the elderly, proper education among staff, patients and their carers is also needed. Proper information provided by medical personnel plays an important role in this matter.