Aging and Addicted to Opioids

When you picture drug abuse, Canadian seniors may not come to mind. But the over-prescription of painkillers has made them another face of the opioid epidemic.

| Summer 2017

Pill bottles

As useful as opioid painkillers are following surgery or acute trauma, their addictiveness leads to questions about prescribing them for long-term use.

Illustration by iStock/mechanismdigital

When Bert Mitchell remembers his motor-vehicle accident in February 2003, the 67-year-old can still see the two tractor-trailers jackknifed ahead of him on Highway 401, just north of Cobourg, Ontario, where he lives. As Mitchell careened toward the pileup, there was a collision in his own mind — a split second of dissonance — between what he would attempt and what he couldn’t possibly avoid. He then stomped on the brake pedal as his Toyota Corolla was rear-ended by another tractor-trailer and driven into and under the stationary trucks just ahead. It took emergency responders several hours to free him from the wreckage — an extrication that he recalls only as scattered images witnessed amid brief moments of consciousness.

When Mitchell finally awoke from an induced coma two weeks later, he found himself in pain so excruciating that he thought he would pass out. The nurses were palpating his chest, clearing fluids from his collapsed lungs. “It’s like the old adage,” he says, still bemused. “I heard someone screaming and then realized it was me.” He was later told that he also had a concussion, 12 broken ribs, two spinal breaks and other internal injuries, as well as a compound fracture in his left arm. 

Several weeks on a morphine drip at Toronto’s Sunnybrook Hospital led to several more weeks at Northumberland Hills Hospital in Cobourg. After finally being discharged, he remained bedridden for the better part of a year, completely dependent on a combination of the opioid pain-relief drugs OxyContin and Oxycocet.

“Taking these painkillers was very pleasant,” Mitchell admits. “The pain would return slowly, but I would take an OxyContin, and then five minutes later, everything was great again. It was a comforting feeling that would wash over my body with every heartbeat. I felt confident,
secure — and happy.” OxyContin also made Mitchell drowsy. Although his midday snoozes were satisfying, he would fall asleep anywhere and at any time — even while behind the wheel of his car. After several near collisions, his wife, Sue, took over the bulk of their driving. 

While recovering at home one day, Mitchell, who was forced to retire as a training technician because of his injuries, was shocked to read about the addictive nature of the drug that he had been taking for more than a year. He
decided to stop cold turkey. “This was a mistake,” he says. “In just a few hours, I felt that something was very wrong.” As the drug’s effects started to wear off, the severe, intractable pain came back in waves until it was all-engulfing. He began to shake and panic. All he knew was that he had to have more OxyContin. It was “impossible to resist.” 

While the prevailing picture of an opioid addict may be a street-involved person living in a place like Vancouver’s Downtown Eastside, a prescription from a family doctor can mark the beginning of a downward spiral into addiction. Mitchell is one of the growing number of North Americans — many elderly — who have overused pain medication in recent years, sometimes with tragic consequences. Opioids like OxyContin and fentanyl have long been prescribed for chronic conditions such as headaches and arthritis, and are highly recommended following surgery or at the end of life. But as opioid-related overdoses and deaths continue to increase, and as our aging population experiences aches and pains with ruthless regularity, physicians are being asked to pause before prescribing opioids to patients.