All-Cause Mortality Risk Higher With Long-Acting Opioids
The value of prescribing long-acting opioids for chronic noncancer pain should be carefully evaluated.
HealthDay News — Opioid use may significantly increase mortality risk, according to a study published in the Journal of the American Medical Association.
Wayne Ray, PhD, from the department of health policy at the Vanderbilt University School of Medicine in Nashville, Tenn., and colleagues analyzed data collected between 1999 and 2012 on 22,912 patients, average age 48, who had been prescribed a long-acting opioid medication. The researchers compared that to data on an equal number of patients who had been given an alternate pain medication, including anticonvulsants and low-dose antidepressants.
During an average tracking period of about four to six months, there were 185 deaths in the opioid group versus 87 deaths in the alternate medication group. In all, the opioid group was found to face a 64% increased risk of death due to any reason, the team found. But the opioid patients also faced a 65% increased risk of death specifically related to new cardiovascular complications.
The study authors concluded that alternate pain medications should be favored over long-acting opioids whenever possible, particularly for those patients who have a history of cardiovascular disease, heart attack, or diabetes. "Our opinion, which is consistent with the recent guidelines from the U.S. Centers for Disease Control and Prevention, is that opioids should be used as a last resort," Ray told HealthDay. "The best way to decide if the benefits outweigh the risks is through a careful practitioner-patient discussion."
Ray WA, Chung CP, Murray KT, et al. Prescription of Long-Acting Opioids and Mortality in Patients With Chronic Noncancer Pain. JAMA. 2016;315:2415-2423.