Opioids double risk of death from any cause

by Bruce Sylvester – taken from the British Medical Journal (BMJ)

Long-term opium use almost doubles the risk of death from many causes, particularly circulatory diseases, respiratory conditions, and cancer, researchers reported in the British Medical Journal online (bmj.com) on April 18.

In an accompanying comment, Irfan Dhalla, MD, St. Michael’s Hospital, Toronto, Ontario, said that “in high-income countries, doctors rarely, if ever, encounter someone who uses opium.” However, he said that millions of patients with chronic pain are prescribed opioids such as morphine and codeine that may carry “risks that are incompletely understood.”

The investigators evaluated data (average of 5 years) on  50,045 Iranian opium users,  men and women aged 40 to 75 years living in Golestan Province in northern Iran.. A total of 17% (8,487) participants reported opium use, with an average duration of 12.7 years. There were 2,145 deaths during the study period.

After adjusting for factors including poverty and cigarette smoking, opium use associated with an 86% increased risk of deaths from several major causes including circulatory diseases, asthma, chronic obstructive pulmonary disease, tuberculosis, and cancer.

Excluding those who self-prescribed opium after the onset of a chronic illness, the use-death associations remained and a dose-response relationship emerged.

Opium ingestion and opium smoking were both associated with a higher risk of death.

The authors estimated that 15% of all deaths in this population was linked to opium use.

They called for more studies on opium use and mortality and of patients taking long-term opioid analgesics for treatment of pain.