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7 questions to ask when you’re given a prescription for an opioid

A discussion with your doctor may minimize your chance of becoming dependent on or addicted to these powerful painkillers.

Opioid misuse is now one of most important health problems in the United States, rivaling smoking as a cause of death. Although news reports tend to focus on an opioid crisis among the young, the opioid epidemic is increasingly affecting older people as well. In fact, the rates of hospitalization for opioid overdoses among Medicare recipients quintupled from 1993 through 2012. Although older people are still less likely than younger ones to become addicted or succumb to opioid overdoses, they are more likely to suffer side effects from extended opioid use, including memory and cognition problems and falls.

"Opioid use and pain management is something we deal with constantly," says Dr. Michael L. Barnett, assistant professor of health policy at the Harvard T.H. Chan School of Public Health. According to a report from the U.S. Department of Health and Human Services, nearly one-third of Medicare beneficiaries received at least one prescription for opioids in 2015, and those who did got an average of five such prescriptions or refills. Dr. Barnett and a team of his colleagues decided to investigate how Medicare recipients get opioid prescriptions in the first place.

The finer points of acupuncture

This ancient practice can be used alone or with conventional therapy to help ease your pain.


 Image: © zilli/Thinkstock

Men looking for an easy and effective means to manage pain should consider acupuncture.

"There are many different types of pain — neuropathic, muscular, degenerative joint — all of which can make management complex," says Hugo Lopez, a licensed acupuncturist with Harvard-affiliated Massachusetts General Hospital Cancer Center. "Sometimes you need to treat not just the physical components, but also the psychological ones, and that is where acupuncture can help, as it addresses both problems."

How depression affects your thinking skills

Don't assume age is to blame for changes in memory, attention, and decision making.


Image: © pixelheadphoto/Thinkstock

Depression has a way of sucking the joy and meaning from life. Chronic feelings of hopelessness, apathy, or despair are part of the condition. It may also bring physical symptoms, such as weight loss, sleep disturbance, fatigue, and aches and pains. But depression can be sneaky, causing subtle changes in thinking skills that you may not attribute to the condition. "Very often, one of the first signs of depression in people ages 70 or older is a change in thinking," says Dr. Helen Farrell, a psychiatrist with Harvard-affiliated Beth Israel Deaconess Medical Center.

What's the connection?

Depression may involve the interruption or reduction of chemical messengers in the brain called neurotransmitters, such as serotonin, dopamine, and norepinephrine. These chemical changes may be the cause of your depression (if the brain systems that regulate them go awry), or they may result from other depression triggers, such as the following:

How the placebo effect may help you

There is growing evidence that the placebo effect is at work in most successful medical therapies.


Image: © BakiBG/Thinkstock

When you were a child, your mother or grandmother might have used a home remedy that made you feel better, especially when it was delivered with a soothing hand on the forehead or a kiss on the cheek. Perhaps she assured you that a cup of warm milk would help you fall asleep, and you found that it did.

Unbeknownst to you — or her — she was probably harnessing the placebo effect, loosely defined as a favorable response to a medical intervention that doesn't have a direct physiological effect. Although you may have learned later in life that there isn't much scientific evidence to support the practice, you may still sleep better after a cup of warm milk at bedtime.

Binge drinking continues to rise — particularly among women and seniors

Data from several surveys indicate that the percentage of women who drink has been increasing for decades. The numerous health effects associated with alcohol consumption mean that women should be especially attentive to how much they drink.

Physicians and opioids: Part of the solution, but challenges ahead

As doctors acknowledge the role that they have played in the current opioid crisis, they, along with hospitals, medical schools, and other members of the medical community have worked to address the issue on several fronts, including instituting prescribing guidelines and offering continuing education to prescribers.

Treating pain after opioid addiction: A personal story

What happens when a person who was addicted to opiates is injured and needs pain medication? A doctor who is in recovery has firsthand experience.

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