June 14, 2016 — Long-acting opiates increase the risk of accidental overdose, but a new study suggests they may also increase the risk of death from cardio-respiratory and other causes.
Opioids can interfere with breathing during the night, which can cause irregular heart rhythms.
Excluding overdoses, opiate painkillers were associated with a 72% increased risk of death compared to other drugs for moderate-to-severe chronic pain, according to a new study published in JAMA.
The risk of cardiovascular deaths was 65% higher among patients on opioids compared to other drugs. Those other drugs included cyclic antidepressants and anticonvulsant drugs, which are used to treat seizures, bipolar disorder, or neuropathic pain.
The study was conducted by Dr. Wayne Ray and colleagues at the Vanderbilt Department of Health. The conclusions were based on data from Tennessee Medicaid patients with chronic pain (mostly back or muscle pain) who did not have cancer or other serious illnesses.
The researchers warned:
“The take-home message for patients with the kinds of pain we studied is to avoid long-acting opioids whenever possible. … [Especially] patients with high risk for cardiovascular disease, such as those with diabetes or a prior heart attack.”
The study involved nearly 23,000 people who were newly-prescribed medications for pain relief between 1999 and 2012. There were 185 deaths among patients on opioids compared to 87 deaths in the control group. Patients on long-acting opioids had 69 excess deaths per 10,000 users, which translates to one extra death for every 145 patients.
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