Opioid Use - Health Care Professionals
Clinical Guidelines
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For Older Adults & Care Partners
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In general, two populations develop opioid use disorder – those with longstanding use since teens or twenties, and those that develop it later in life after prescription exposure for pain. In 2015, older adults in Canada were the age group with the highest prevalence of hospitalization due to opioid overdose.
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Read the Guidelines
Discover these evidence-based guidelines and best practice recommendations on the prevention, identification, assessment, and management of opioid use disorder among older adults.
Important takeaways from these guidelines
- To reduce the risk of developing OUD, opioid prescriptions should be the lowest effect dose of the least potent immediate release opioid for three days or less and rarely seven days or more.
- Non-opioid and non-pharmacological strategies are preferable to opioids.
- When treating older adults with OUD, buprenorphine-naloxone should be considered first-line for withdrawal management and opioid maintenance treatment. Methadone is an alternative. For select patients, either slow-release oral morphine or opioid antagonist treatment with naltrexone may be used.
- Behavioural techniques, particularly contingency management, can be offered (but not required) in conjunction with pharmacological management of OUD in older adults.
Discover Online Resources for Opioid Use Disorder
This list is designed to help primary health care & clinical care providers assess and discuss with persons aged 65 or older, the potential risks and benefits of opioid use.
Read the publication in the Canadian Geriatrics Journal (March 2020)
Watch the webinar below which summarizes the Clinical Guidelines on Opioid Use Disorder Among Older Adults.
Dr. Launette Rieb is a family physician, addiction medicine specialist, researcher, and Clinical Associate Professor in the Department of Family Practice at the University of British Columbia. She works clinically as a consultant at The Rapid Access Addictions Clinic at St. Paul's Hospital, at CBI Health Centre as Medical Director of a multidisciplinary pain team, and at the Orchard Recovery Centre - a residential drug and alcohol treatment facility.
Watch the following National ECHO webinar substance use disorder in older adults.
Jonathan Bertram, MD, CCFP, is an addiction medicine physician at the Centre for Addiction and Mental Health with a special interest in First Nations outreach, and older adults in the context of pain and addictions treatment. He is a consultant physician on geriatric addictions management to Community Outreach Programs in Addictions (COPA), and runs a community practice in pain, family medicine and addictions in Bowmanville, Ontario.
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