When Pain Pills Put Seniors at Risk: New Study Links Neuropathic Drugs to Hip Fractures

There’s a reason that the first medicines humanity discovered were for controlling pain. Not curing infection. Not stopping bleeding. As early as the ancient Sumerians, humans had invented analgesics: substances that dulled the endless grinding of pain.

Anyone who has been in chronic pain, or has sat with a loved one suffering through it, knows how quickly it can fray the spirit as well as the body. And what was that first pain reliever from 4000 B.C.? 

Its name translates to “milk of the poppy.” 

The first opioid.

In the twenty-first century, as conventional wisdom has turned against opioids, clinicians have had to search for alternatives.

Because of this, in the last decade, prescriptions for gabapentinoids – the class of drugs that includes gabapentin and pregabalin – have exploded. 

In Australia, the number of people taking gabapentinoids jumped eightfold between 2012 and 2018, and by 2018, nearly one in seven Australians aged 80 and older had been prescribed one of these medicines. The drugs are widely viewed as a “safer” option for neuropathic pain because they modulate calcium channels rather than opioid receptors, and their use has grown in the United States and Europe for everything from shingles to diabetic neuropathy.

Yet a recent case‑case‑time‑control study published in JAMA Network Open suggests that this sense of safety comes with a hidden cost. Researchers followed 28,293 patients hospitalized for hip fractures in Victoria, Australia, and identified those who had received gabapentinoids in the months before their injury. The results were sobering: patients had a 30% increased odds of suffering a hip fracture within two months of being dispensed a gabapentinoid. After adjusting for other central‑nervous‑system medications, the increased risk remained significant.

Why gabapentinoids raise the stakes

Gabapentinoids cross the blood–brain barrier and inhibit neurotransmitter release at multiple points, which is why they are effective for seizures and neuropathic pain. 

The downside is a suite of central‑nervous‑system adverse effects – somnolence, dizziness, gait disturbance, and balance disorder. 

These side effects are not trivial. 

In the Monash study, investigators found that the link between gabapentinoid use and hip fractures existed across all age groups, but frail patients and those with chronic kidney disease were particularly vulnerable. When investigators stratified the data by frailty, the odds of hip fracture were 75% higher for patients with a hospital frailty risk score of five or more and more than twice as high for those with chronic kidney disease.

This association comes at a time when hip fractures already impose a heavy burden. In Australia, more than 20,000 new hip fractures are reported each year and 93% result from falls. The consequences are grim: about one in four patients die within a year of a hip fracture, and many survivors never regain full independence. 

Experts estimate that in the United States, falls cost the health‑care system over $50 billion annually, while a single hip fracture can exceed $39,000 in medical costs. 

A cautionary tale, not a condemnation

One should resist the temptation to throw gabapentinoids out with the bathwater. 

Professor Simon Bell, director of the Centre for Medicine Use and Safety and a co‑author of the Monash study, reminds patients that gabapentinoids remain an effective option for neuropathic pain but that clinicians must weigh the risks and benefits. He notes that dizziness and balance problems are more common in older people and that the odds of hip fracture were highest among patients who were frailer or had chronic kidney disease. 

Lead author Miriam Leung urges general practitioners to assess each patient’s risk of falls before prescribing and to discuss potential side effects. The study underscores a broader theme: medication choices have ripple effects, especially for seniors whose fall risk is already elevated.

For caregivers and family members, the takeaway is not to abruptly stop medications, but to talk with prescribing physicians about the safest pain‑management strategies, or, as Briggs Health Solutions will soon be bringing onto the medical-wearable scene, consider a fall protection option when fall prevention isn’t enough.

When prevention fails, innovation can catch the fall

Innovators are exploring new ways to mitigate the impact of falls. One intriguing example comes from Briggs Health Solutions, the company behind the Smart Hip Guardian. This device resembles a lightweight belt about the size of a fanny pack, but inside is a suite of sensors and an airbag system. The smart‑sensing belt distinguishes between everyday movements and a true fall. If a fall is detected, it deploys an airbag in approximately 0.2 seconds before impact, cushioning the hips and absorbing much of the force. 

The design is discreet, using a quick‑snap buckle so it does not interfere with day‑to‑day activities.

The technology isn’t just theoretical. Briggs Health Solutions reports that over 25,000 tests, including an 18‑month dynamic fall study at the University of Pittsburgh medical school, have demonstrated the device’s effectiveness. Third‑party testing by National Technical Systems confirms that the belt significantly reduces impact forces. Dr. Bruce Myers, a physical‑medicine specialist and medical advisor to the company, calls the Smart Hip Guardian “a game changer for the future of geriatric health care and safety” and notes that it “can help prevent hip fractures, preventing suffering and saving lives.”

Another thoughtful feature is the companion smartphone app, which notifies caregivers if a fall has occurred and provides data on when and how it happened. The app also monitors the belt’s charge status, so users and family members can ensure it is ready to deploy. For adult children juggling careers and caregiving responsibilities, this combination of real‑time protection and peace of mind may be as important as the physical cushioning.

As caregivers and health‑care professionals continue to navigate the opioid crisis and the ongoing need for effective pain management, they must also weigh the costs of new therapies against the risks they introduce. Keeping seniors safe requires vigilance, informed decision‑making, and, sometimes, a willingness to embrace innovation. In the meantime, if you’re part of the sandwich generation or have loved ones at risk of falls, it might be worth looking into what smart technology can do for peace of mind.

Follow Briggs Health Solutions on LinkedIn for more insights into fall prevention and the future of geriatric safety.