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Pain Management in the Older Adult with Opioid Use Disorder
Rebecca Ellis1, Rebecca Rodin2
1Department of Medicine, Division of Palliative Care, University of Rochester Medical Center, School of Medicine and Dentistry 601 Elmwood Ave, Box 687 Rochester, NY 14642, USA.
Clinics in Geriatric Medicine
|November 21, 2025
Summary
Managing pain in older adults with addiction is complex. This article reviews strategies for opioid misuse and opioid use disorder, focusing on buprenorphine and methadone for pain and addiction treatment.
Area of Science:
- Geriatrics
- Addiction Medicine
- Pain Management
Background:
- Older adults face high rates of chronic pain and complex medical/psychosocial needs.
- Addiction prevalence challenges effective pain management in this demographic.
- Limited guidance exists for managing pain in older adults with opioid misuse and opioid use disorder (OUD).
Purpose of the Study:
- To explore diagnostic and treatment strategies for older adults with opioid misuse and OUD.
- To provide special attention to pharmacotherapy for comorbid pain and addiction.
Main Methods:
- Literature review of diagnostic and treatment approaches.
- Focus on pharmacologic interventions, including buprenorphine and methadone.
- Consideration of unique challenges in older adults, such as heightened pain sensitivity and comorbidities.
Main Results:
- Older adults with opioid misuse/OUD present unique treatment complexities.
- Pharmacotherapy with buprenorphine and methadone shows promise for managing comorbid pain and addiction.
- Tailored diagnostic and treatment strategies are essential for this population.
Conclusions:
- Effective pain management in older adults with addiction requires specialized approaches.
- Buprenorphine and methadone are key pharmacotherapies for concurrent pain and OUD treatment.
- Further research is needed to optimize care for this vulnerable group.
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