Editor's Correspondence |

A Painful Setback: Misinterpretation of Analgesic Safety in Older Adults May Inadvertently Worsen Pain Care

Ula Hwang, MD, MPH; R. Sean Morrison, MD; Lynne D. Richardson, MD; Knox H. Todd, MD, MPH
Arch Intern Med. 2011;171(12):1127. doi:10.1001/archinternmed.2011.262.
Text Size: A A A
Published online


Observational findings by Solomon et al1 of safety events associated with opioid and nonsteroidal anti-inflammatory drugs (NSAIDs) have made headline news and are now at risk of misinterpretation and potentially worsening overall pain care for older adults. The studies have significant limitations that may preclude the implications investigators and journal editors hope to convey. While propensity scores were used to methodologically adjust for the limitations of Medicare and pharmacy claims data, sizeable confounders, including the severity of pain experienced by subjects, the type of medications used (including over-the-counter analgesics), and more importantly, the dose and duration of medication use could not be accounted for.1 Despite these shortcomings, the results have received considerable attention. The general public and medical communities have been quick to caution against the use of opioids and analgesics in older adults. Alarmist headlines with phrases such as “Narcotic Painkillers” and “Hazards in Elderly” were found in national headlines24 and medical Web sites57 immediately after results were released.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles