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Canadian Guidelines on Opioid Use Disorder Among Older Adults
Launette M Rieb1, Zainab Samaan2, Andrea D Furlan3
1Department of Family Practice, University of British Columbia, Vancouver, BC.
Canadian Geriatrics Journal : CGJ
|April 1, 2020
Summary
Opioid use disorder (OUD) affects older adults disproportionately. New Canadian guidelines recommend prioritizing non-opioid pain management and using buprenorphine as a first-line treatment for OUD in seniors.
Area of Science:
- Geriatric Medicine
- Public Health
- Pharmacology
Background:
- Opioid overdose hospitalizations are higher in Canadian adults aged 65+.
- Opioid use disorder (OUD) presents a growing concern for the elderly population.
- Health Canada developed guidelines for OUD in older adults.
Purpose of the Study:
- To establish comprehensive guidelines for OUD prevention, screening, assessment, and treatment in older adults.
- To address the specific needs and challenges of OUD in the geriatric population.
- To provide evidence-based recommendations for Canadian healthcare providers.
Main Methods:
- A systematic review of English literature (2008-2018) on OUD in adults was performed.
- Existing guidelines were evaluated using AGREE II and updated with the ADAPTE method.
- Recommendations were developed and assessed using the GRADE method.
Main Results:
- Thirty-two recommendations were formulated for OUD management in older adults.
- Prioritizing non-pharmacological and non-opioid strategies for pain management is recommended.
- Buprenorphine is identified as the first-line treatment for OUD withdrawal and maintenance, with alternatives available.
Conclusions:
- The developed guidelines offer practical and timely clinical recommendations for OUD in older adults.
- These guidelines support the prevention, assessment, and treatment of OUD within the Canadian healthcare system.
- Integrated non-pharmacological treatments are emphasized as part of comprehensive OUD care.
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