Long-acting opioid therapy linked to increased mortality risk
Prescription of long-acting opioid medications for chronic, noncancer pain is associated with an increased risk of all-cause mortality when compared to alternative medications, according to research published in JAMA.
Wayne A. Ray, PhD, Vanderbilt University School of Medicine, Nashville, and colleagues conducted a retrospective cohort study of Tennessee Medicaid patients with chronic, noncancer pain between 1999 and 2012. Patients had received either long-acting opioid therapy or comparable therapy with either an analgesic anticonvulsant or low-dose cyclic antidepressant. Patients had not received palliative or end-of-life care.
The researchers found 22,912 new episodes of prescribed therapy for both long-acting opioids and control medications; 185 deaths were recorded in the long-acting opioid group, compared to 87 deaths recorded in the control group. Data analysis showed that patients who were prescribed long-acting opioid therapy had a 1.6 times greater risk of all-cause mortality and a 1.9 times greater risk of out-of-hospital death.
“More than two-thirds of the excess deaths were due to causes other than unintentional overdose; of these, more than one-half were cardiovascular deaths,” noted Dr Ray. “These findings should be considered when evaluating harms and benefits of treatment.”
Filed under: General Problems
I respectfully disagree,,I do believe if it is an adult,,,they have something called ,”free will,” where it is their choice to take toooo many or not follow their doctors prescribed dosage,,,I do believe as adults it is our ,”free will,” to become a true addict,,,not a person in physical pain who needs their medicines for medical reasons,,,someone who takes a ,”drug,”’ excessivelly for NO medical purpose..And,, excellent point about basically propaganda and grief distorting once judge ments,,,jmo,,,however when both are used to prove a lie,,,ie,,,that my medicines is some sorta street drug,,a lie,,,or somehow it is the Doctors fault or the medicines fault your ADULT daughter/son choose to o.d. or abuse it,,,,they both are just being used to justify a PERSONAL opinion,,,ie revenge or their believe my medicines are the cause of their adults son/daughter abuse,,thus not putting the blame squarely where is belongs,,,on that adult,,for being irresponsible as an ADULT w/their free will,,,jmo,,maryw
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By the sound of it, this is just another reduced fact study produced by government sponsored physicians to supply false data to lawmakers. There is no way that pulling a bunch of names out of the Medicare hat of pain patients can be as accurate as this dippshit doctor is saying.
First, how can you honestly determine mortality rates on Medicare patients simply by looking who took opiates and who took alternatives and when or at what age they died? We all know that every case of chronic pain is different.
Second, inorder to have truly accurate statistics, every single patient would have to be exactly the same age and have the very same ailments.
Finally, how many of these Medicare patients were male and how many were female? How many were white, Hispanic, oriental, native American or African Americans? Pain effects us all different and this doctor just produced his findings on a less than controlled study. This is like me saying that I did a study on 100 dogs and found that 30% of dogs are left handed, 60% are right handed and 10% are ambidextrous because of the direction they spin in before they shit. It’s just not real science!
Are they sure those numbers are correct? .my most recent visit to my PCP 3 months ago, i was having a full blown migraine and i don’t get narcotics for it. Since I had to myself to the appt, I couldn’t take my major migraine medications, just my beginning ones. My BP was 130/100. I do not have high blood pressure nor am I on any blood pressure medication. Needless to say they were concerned. I told them.my BP goes WAY up when I have a migraine. I tried BP meds as preventive but all they did was bottom it out and make me feel sick. Any higher, yes puts me at risk for stroke, but apparently the alphabet soup gurus in governmemt dont see it that way….yarh pain will certainly disable you if not kill you if not treated…..Vote the bums out!!!!
An article in the NY Times last month also mentions cardiac risks with long-term use of opioids, which I had never heard before. Of course, the article doesn’t mention that chronic pain also causes cardiac risks.
“Patients had received either long-acting opioid therapy or comparable therapy with either an analgesic anticonvulsant or low-dose cyclic antidepressant.”
When you’re in more pain, you take stronger drugs. So, perhaps the patients taking antidepressants or anticonvulsants were in less pain than the group taking opioids. And what other drugs were these patients taking? Also, you can’t really compare patient groups without knowing their medical conditions, some of which could signal an earlier mortality rate.
I would say that, generally, those who take opioids are poorer than those who take weaker drugs (many of whom have the financial ability to combine drugs with alternative therapies). And since this study is of a Medicaid patient population, poverty is obviously a factor.
Poverty (less access to quality health care, more stress, cheap diets, etc.) is something that should always be taken into account when talking about causes of death. I would say that poverty is more of a strain on the heart than long-term use of opioids.
“1.6 times greater risk of all-cause mortality and a 1.9 times greater risk of out-of-hospital death.”
Is this even statistically relevant?
no,,it is not relavent,,,,,but it does corrupt the minds of all those opiatephobs,, ,ie,,,opiates bad,bad,bad,,thus,,,propaganda,,u know I just finish seeing a add from, Partnership for drug free kids,.,of a ADULT,,, in a wheel chair,,who had some sorta of stroke SUPPOSEDLY FROM abusing his prescribed MEDICINES when he was 17,,AND HIS PARENT BY HIS SIDE,,, saying prescribed medicine did this,,,,now,,,does anyone else see the propaganda in this? ,,,,,its a ADULT being portray on a site that is suppose to promote drug fee CHILDREN,, I am seeing more and more adds w/this type of propaganda,,and I just witness the senator from P.A. stating he wants no-more hippa laws so parents of ADULT children can snoop into their ADULTS son/daughter private medical history,,,Which as many of us know,,are the people who are going after our doctors,,PARENTS of adult son/daughter are the ones going after our doctors,,because they disagree w/what they perceive as their ,’/’child,” not a ADULT,, but perceive them as their CHILDREN,,, sueing our doctors because their kid chooses to o.d.,,,The law states at 18,,,u r an adult,,u can be drafted to die for this country,,,but too many controlling parents want someone to blame other then their son/daughter who as an adult made the wrong choice in abusing their medicines,,There is a huge difference between grief and revenge,,,,,any parent who goes after the doc of their adults son/daughter are doing it for revenge only!!!!!sorry a little off topic,,,but sooo many things tie into each other in this whole mess of willfull torture and genocide onto the medically ill w/physically painful medical conditons,,,maryw
I don’t believe that drug addiction is a choice, nor do I think that most people choose to OD. I do believe that grief can distort a person’s reasoning capabilities, but then, so can politics.
No — it’s not relevant. But may I suggest a factor that probably would have been relevant, had it been considered in the “study?” NSADs. If the “non-opioid” group (or some of them) had been treated with NSAIDs for paid, we might be looking at a very different adverse long-term outcomes, including death. Even if I stretch my imagination to the point of fantasy, I’m unable to come up with more cherry-picked group likely to have the least adverse effects than “a comparable therapy with either an analgesic anticonvulsant or low-dose cyclic antidepressant[!!!]” Or a more unrealistic one.
And why was the opioid-using group in this study only those prescribed “long-acting” (i.e. time release/extended release) opioids? Personally, I feel it likely that an ill-advised shift to the prescribing of long-acting opioids to some patients who should have been prescribed only the shorter-acting, “traditional” opioid pain meds, has contributed to the problem (among other things). But I don’t have any figures on that to offer — mainly because I don’t see studies on those potentially major factors coming across my screen — I assume because such studies & [desperately] needed info isn’t compatible with the anti-opioid-agenda so many appear to be pushing in recent years (& going back to 2004 – ’05, but that’s another subject).
What are the ages of these patients? What were there cardiovascular risk factors before the study began? Were they able to afford all medications for CV health? In SC Medicaid only pays for 4 prescriptions per month….not much for anyone with comorbidoties associated with chronic pain and or cardiovascular issues. Skewed data published !!! Such a shame that people will believe this !!!
Being forced to suffer in pain does good for the heart , along with steroids anti-inflammatorities. ..