OBJECTIVES To assess the risk of injury associated with the use of select analgesics in the elderly. METHODS Logistic regression analysis performed to examine the risk of injury-related ER visits following the use of select analgesic medications. Demographic characteristics of CMS-HCC risk score, age, gender, and origin are reported as regressors. RESULTS Separate analyses performed to assess the likelihood of an injury-related emergency room visit when the reference group under study was morphine, methadone, and propoxyphene recipients. For morphine, all medications analyzed were found to have a higher likelihood of an injury-related ER visit as compared to morphine, except for fentanyl (p>0.05). Coding methadone as the reference group, only ketorolac, pentazocine and meperidine recipients had a higher likelihood of having an injury-related ER visit as compared to recipients of methadone (OR 1.411, 95% CI 1.301-1.530; OR 1.183, 95% CI 1.089-1.284; and OR1.181, 95% CI 1.097-1.273, respectively). Designating propoxyphene as the reference group, only ketorolac, pentazocine, meperidine, methadone, and hydrocodone recipients had a higher likelihood (OR 1.470, 95% CI 1.367-1.581; OR 1.232, 95% CI 1.144-1.327; OR 1.231, 95% CI 1.153-1.314; OR 1.042, 95% CI 1.004-1.081; OR 1.047, 95% CI 1.038-1.057, respectively). Regarding demographics, Caucasian origin, male gender, middle-age elderly, and high CMS-HCC risk scores were found to be factors influencing injury-related ER visits for elderly analgesic recipients. CONCLUSIONS Morphine is a very suitable opioid for use in the elderly. Methadone, a non-Beers medication, is a problematic opioid needing further assessment by the clinical community for possible assignment to the Beers list. Propoxyphene, currently a low severity rated Beers medication, needs further assessment for possible reassignment to a high severity rating.