"The increase in falls and fractures was strongly associated with the increased use of opioids as opposed to Tylenol or other pain medications," Dr. Rolita says.

The findings come at a time that the Centers for Disease Control and Prevention, or CDC, reports that the death toll from overdoses of prescription painkillers has more than tripled in the past decade, with more than 40 people dying every day from overdoses of opioids like hydrocodone, methadone and oxycodone.

The epidemic is blamed largely on misuse of prescriptions for nonmedical reasons, but increasing use of drugs for pain control is a contributing factor as well, according to the CDC.

That's all the more reason to take steps to reduce the use of opioid painkillers among older patients, according to experts. In elderly patients, who are prone to falls for other reasons, just taking opioid painkillers – not abusing them – is associated with more falls and fractures, says Eric Matteson, MD, chair of the division of rheumatology at the Mayo Clinic in Rochester, Minn. Dr. Matteson was not involved in the study.

The problem is that treatment options for people with chronic pain due to arthritis are limited. "If you take away opioids and NSAIDs, what's left?” he asks. “Tylenol (acetaminophen) … joint injections, and nonpharmacological measures such as acupuncture and weight loss."

Rather than eliminating NSAIDs and substituting opioids, Dr. Matteson says, NSAIDs need to used more judiciously.

"Instead of taking them every six to eight hours, as the label states, I tell patients to only take them when really needed for pain," he says. "Or, take a lower dose of an NSAID like Advil plus one Tylenol to get equivalent pain relief to two Advil tablets."

Scott Zashin, MD, who moderated a press conference in which the study results were discussed, has another suggestion: Keep an eye on the patient. He recommends that a family member or visiting nurse stay for a few days with an elderly patient starting a opioid painkiller to ensure the drug doesn’t make him confused or drowsy. And they should come back weekly to check on the patient.

Opioids should not be given "a totally bad rap," says Dr. Zashin, a clinical associate professor of medicine at the University of Texas Southwestern Medical School in Dallas. "They can be effective painkillers."