Other Titles
Older Adults in Chronic Pain Following an Opioid Taper [Title Slide]
Other Titles
Rapid Presentation Round
Abstract
As the older adult population increases, so does the prevalence of conditions associated with chronic pain (Tinnirello et al., 2021). Chronic pain, defined as lasting longer than three months, affects approximately 20.8% (50.2 million) of adults (Nahin et al., 2023; Yong et al., 2022; Zelaya, 2020), of whom almost 20.5 million are age 65 and over (Rickard et al., 2023). Pain is the leading cause of disability, costing up to $635 billion annually (Turk et al., 2022; Institute of Medicine, 2011). Chronic pain in older adults causes significant suffering (Dahlhamer et al., 2016), social isolation (Tsang et al., 2008), increased costs (Bernfort et al., 2015; Yong et al., 2022), disability, and burden to healthcare systems (Patel et al., 2013; Leveille et al., 2009; Pitcher et al., 2018). Approximately 10 million Americans receive long-term opioid prescriptions (Mazurenko et al., 2022; Mojtabai, 2018) for chronic pain management. In 2016, the Centers for Disease Control and Prevention (CDC) published Opioid Prescribing Guidelines to curtail the number of patients who are prescribed opioids due to their addictive properties. These guidelines recommend that providers prescribe the lowest effective dose of opioids for chronic pain. Many providers, medical systems, and insurance companies interpreted the guidelines as mandatory, causing many chronic pain patients to undergo forced opioid drug tapering (Dowell, 2022; Pergolizzi et al., 2019). Despite the CDC revising its guidelines in November 2022, healthcare providers continue to resist treating chronic pain with opioids, even for long-term stable patients. Recent research highlights the adverse effects of opioid tapering on older adults, leading to increased emergency department visits and hospitalizations (Magnan et al., 2023).
Problem Statement: Tapering opioids in older adults with chronic pain may result in significant suffering and a poor quality of life.
Purpose Statement: The purpose of this study is to describe the lived experiences of older adults following an opioid taper.
Significance: Understanding older adults’ experiences with pain and quality of function following an opioid taper may offer enhanced perspectives regarding the efficacy of current opioid prescribing practices.
Originality: Few studies exist to support the benefits of opioid tapering in older adults or demonstrate that long-term opioid use in older adults with chronic pain causes adverse effects.
Notes
References:
Dahlhamer, J., Lucas, J., Zelaya, C., Nahin, R., Mackey, S., DeBar, L., Kerns, R., Von Korff, M., Porter, L., & Helmick, C. (2016). Prevalence of chronic pain and high-impact chronic pain among adults – United States, MMWR, 67(36), 1001–1006. https://doi.org/10.15585/mmwr.mm6736a2
Dowell, D. (2022). CDC clinical practice guideline for prescribing opioids for pain—United States, 2022. MMWR. Recommendations and reports, 71.
Leveille, S. G., Jones, R. N., Kiely, D. K., Hausdorff, J. M., Shmerling, R. H., Guralnik, J. M., Kiel, D. P., Lipsitz, L. A., & Bean, J. F. (2009). Chronic musculoskeletal pain and the occurrence of falls in an older population. JAMA, 302(20), 2214–2221. https://doi.org/10.1001/jama.2009.1738
Magnan EM, Tancredi DJ, Xing G, Agnoli A, Jerant A, Fenton JJ. Association Between Opioid Tapering and Subsequent Health Care Use, Medication Adherence, and Chronic Condition Control. JAMA Netw Open. 2023;6(2):e2255101. doi:10.1001/jamanetworkopen.2022.55101
Mazurenko, O., Blackburn, J., Zhang, P., Gupta, S., Harle, C. A., Kroenke, K., & Simon, K. (2023). Recent tapering from longterm opioid therapy and odds of opioid related hospital use. Pharmacoepidemiology and Drug Safety, 32(5), 526-534.
Mojtabai R. (2018). National trends in long-term use of prescription opioids. Pharmacoepidemiology & Drug Safety, 27: 526–534.
Nahin RL, Feinberg T, Kapos FP, Terman GW. Estimated Rates of Incident and Persistent Chronic Pain Among US Adults, 2019-2020. JAMA Netw Open. 2023;6(5):e2313563. doi:10.1001/jamanetworkopen.2023.13563
Oliva, E. M., Bowe, T., Manhapra, A., Kertesz, S., Hah, J. M., Henderson, P., Robinson, A., Paik, M., Sandbrink, F., Gordon, A. J., & Trafton, J. A. (2020). Association between stopping prescriptions for opioids, length of opioid treatment, and overdose or suicide deaths in US veterans: Observational evaluation. British Medical Journal, 368, 1–10. https://doi.org/10.1136/bmj.m283
Patel, K. V., Guralnik, J. M., Dansie, E. J., & Turk, D. C. (2013). Prevalence and impact of pain among older adults in the United States: Findings from the 2011 National Health and Aging Trends Study. Pain, 154(12), 2649–2657. https://doi.org/10.1016/j.pain.2013.07.029
Perez, H. R., Buonora, M., Cunningham, C. O., Moonseong, H., & Starrels, J. L. (2020). Opioid taper is associated with subsequent termination of care: A retrospective cohort study. Journal of General Internal Medicine, 35(1), 36–42. https://doi.org/10.1007/s11606-019-05227-9
Pergolizzi, J. V., Rosenblatt, M., & LeQuang, J. A. (2019). Three years down the road: The aftermath of the CDC guideline for prescribing opioids for chronic pain. Advances in Therapy, 36(6), 1235–1240. https://doi.org/10.1007/s12325-019-00954-1
Pitcher, M. H., Von Korff, M., Bushnell, M. C., & Porter, L. (2018). Prevalence and profile of high-impact chronic pain in the United States. The Journal of Pain, 20(2), 146–160. https://doi.org/10.1016/j.jpain.2018.07.006
Rikard, S.M., Strahan, A.E., Schmit, K.M., Guy, Jr., Chronic Pain among adults – United States, 2019 – 2021. MMWR Morb Mortal Wkly Reb 2023;72:379-385.
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Sullivan, M. D., Boudreau, D., Ichikawa, L., Cronkite, D., Albertson-Junkans, L., Salgado, Gladys, VonKorff, M., & Carrell, D. S. (2020). Primary care opioid taper plans are associated with sustained opioid dose reduction. Journal of General Internal Medicine, 35(3), 687–695. https://doi.org/10.1007/s11606-019-05445-1
Tinnirello, A., Mazzoleni, S., & Santi, C. (2021). Chronic pain in the elderly: mechanisms and distinctive features. Biomolecules, 11(8), 1256.
Tsang, A., VonKorff, M., Lee, S., Alonso, J., Karam, E., Angermeyer, M. C., Borges, G. L. G., Bromet, E. J., Demytteneare, K., de Girolamo, G., de Graaf, R., Gureje O., Lepine, J.-P., Haro, J. M., Levinson, D., Oakley Browne, M. A., Posada-Villa, J., Seedat, S., & Watanabe, M. (2008). Common chronic pain conditions in developed and developing countries: Gender and age differences and comorbidity with depression-anxiety disorders. The Journal of Pain, 9(10), 883–891. https://doi.org/10.1016/j.jpain.2008.05.005
Turk, D. C., & Patel, K. V. (2022). Epidemiology and economics of chronic and recurrent pain. Clinical pain management: A practical guide, 6-24.
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Sigma Membership
Xi Mu
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Policy and Advocacy, Primary Care, Ethics, Clinical Practice, Promoting Clinical Outcomes, Older Adults, Pain Management, Chronic Pain, Quality of Life, Long-term Opioid Use, Opioid Tapering
Recommended Citation
Concia, Carolyn D., "Tapering Opioids in Older Adults with Chronic Pain" (2025). Biennial Convention (CONV). 186.
https://www.sigmarepository.org/convention/2025/presentations_2025/186
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-12-05
Tapering Opioids in Older Adults with Chronic Pain
Indianapolis, Indiana, USA
As the older adult population increases, so does the prevalence of conditions associated with chronic pain (Tinnirello et al., 2021). Chronic pain, defined as lasting longer than three months, affects approximately 20.8% (50.2 million) of adults (Nahin et al., 2023; Yong et al., 2022; Zelaya, 2020), of whom almost 20.5 million are age 65 and over (Rickard et al., 2023). Pain is the leading cause of disability, costing up to $635 billion annually (Turk et al., 2022; Institute of Medicine, 2011). Chronic pain in older adults causes significant suffering (Dahlhamer et al., 2016), social isolation (Tsang et al., 2008), increased costs (Bernfort et al., 2015; Yong et al., 2022), disability, and burden to healthcare systems (Patel et al., 2013; Leveille et al., 2009; Pitcher et al., 2018). Approximately 10 million Americans receive long-term opioid prescriptions (Mazurenko et al., 2022; Mojtabai, 2018) for chronic pain management. In 2016, the Centers for Disease Control and Prevention (CDC) published Opioid Prescribing Guidelines to curtail the number of patients who are prescribed opioids due to their addictive properties. These guidelines recommend that providers prescribe the lowest effective dose of opioids for chronic pain. Many providers, medical systems, and insurance companies interpreted the guidelines as mandatory, causing many chronic pain patients to undergo forced opioid drug tapering (Dowell, 2022; Pergolizzi et al., 2019). Despite the CDC revising its guidelines in November 2022, healthcare providers continue to resist treating chronic pain with opioids, even for long-term stable patients. Recent research highlights the adverse effects of opioid tapering on older adults, leading to increased emergency department visits and hospitalizations (Magnan et al., 2023).
Problem Statement: Tapering opioids in older adults with chronic pain may result in significant suffering and a poor quality of life.
Purpose Statement: The purpose of this study is to describe the lived experiences of older adults following an opioid taper.
Significance: Understanding older adults’ experiences with pain and quality of function following an opioid taper may offer enhanced perspectives regarding the efficacy of current opioid prescribing practices.
Originality: Few studies exist to support the benefits of opioid tapering in older adults or demonstrate that long-term opioid use in older adults with chronic pain causes adverse effects.
Description
This study focuses on the impact of opioid tapering on older adults with chronic pain due to the unintended consequences of the 2016 CDC Opioid Prescribing Guidelines, as providers force tapered their patients off opioids. Patient well-being following an abrupt or gradual opioid taper has not been clearly explained. Understanding older adults’ experiences with pain following an opioid taper may offer providers enhanced perspectives regarding the efficacy of current opioid tapering practices.