Analgesic Drugs, Epidemiology, Older Adult, Prescription Opioid Misuse, Prevention, Risk Factors, Screening, Surgical Populations



  1. Dahlem, Chin Hwa PhD
  2. Schepis, Ty S. PhD
  3. McCabe, Sean Esteban PhD
  4. Rank, Aaron L. MD
  5. Kcomt, Luisa PhD
  6. McCabe, Vita V. MD
  7. Voepel-Lewis, Terri PhD


Abstract: The United States and many other developed nations are in the midst of an opioid crisis, with consequent pressure on prescribers to limit opioid prescribing and reduce prescription opioid misuse. This review addresses prescription opioid misuse for older adult surgical populations. We outline the epidemiology and risk factors for persistent opioid use and misuse in older adults undergoing surgery. We also address screening tools and prescription opioid misuse prevention among vulnerable older adult surgical patients (e.g., older adults with a history of an opioid use disorder), followed by clinical management and patient education recommendations. A significant plurality of older adults engaged in prescription opioid misuse obtain opioid medication for misuse from health providers. Thus, nurses can play a critical role in identifying those older adults at a higher risk for misuse and deliver quality care while balancing the need for adequate pain management against the risk for prescription opioid misuse.