The known harms of opioid addiction and overdose may be just the beginning of the known risks of opioids.New research published in pain journal On Nov. 27, it suggested that prescription opioids can also affect the cardiovascular system.
“Aside from the harms of opioids that we know so well, there are other harms that we have yet to uncover,” said Dr. Lecturer in Medicine (General Medicine and Addiction Medicine) and lead author of the study. Dr. Minhee Song says:
Clinicians may prescribe opioids to treat moderate to severe pain, including chronic pain, which affects more than 50 million Americans. It is particularly prevalent in people over the age of 65, affecting 60-75% of this population. “Chronic pain is one of the most common symptoms experienced by older adults,” he says Sung. The sheer number of patients who may be prescribed opioids raises further concerns about their use, especially among patients at high risk for heart disease.
opioid Use may increase risk of cardiovascular disease
Building on a body of research to understand the harms associated with prescribed opioids, in the latest study, the team led by Song analyzed data from the Veterans Aging Cohort Study (VACS). Researchers focused on approximately 50,000 patients over a three-year period, including those who received prescription opioids. Researchers found that people who were prescribed opioids were significantly more likely to develop cardiovascular disease (CVD) later in life. Researchers also found that higher doses were associated with a higher risk of CVD.
“This represents a huge number of patients because so many patients are older, experience chronic pain, take opioids, or are already at risk for cardiovascular disease. It’s very important to the American people,” Sung said.
We want to learn more about how long-term use of prescribed opioids affects the risk of cardiovascular disease and the mechanisms that cause these risks.
Dr. E. Jennifer Edelman
The study cohort included patients prescribed opioids for both short- and acute-onset conditions. [less than 90 days] and long term [90 days or more] Duration ranges from 3 to 23 days in most patients. For future research, “we are interested in learning more about how long-term use of prescribed opioids affects the risk of cardiovascular disease and the mechanisms that drive these risks,” says Professor of Medicine, General Medicine ) says E. Jennifer Edelman, MD. Senior author of this study. “Further research is needed to understand whether it is related to the prescribed opioid itself or to exposures that often occur concurrently with prescribed opioids.”
cardiovascular disease Risks need to be considered in chronic pain treatment
As awareness of the dangers of opioids increases, Song says clinicians need to be careful when treating patients with chronic pain. However, the risks of abruptly discontinuing the drug must also be considered, especially given that other effective pain management options are limited.
“Given the opioid epidemic and increased scrutiny of opioid prescribing, many clinicians are considering alternative solutions to treat pain for people who have long-standing dependence on opioids or who suffer from severe chronic pain. “They suddenly stopped prescribing opioids without offering a plan,” she says. . Research shows that this sudden discontinuation can cause significant psychological stress and increase the risk of suicide.
Sung advises patients age 65 and older, those with diabetes or other risk factors for cardiovascular disease to discuss a pain management plan with their health care provider. “If you’re already at high risk for cardiovascular disease, talk to your doctor about other ways to treat your pain,” she says. Her options include non-drug treatments such as physical therapy and cognitive behavioral therapy for chronic pain.
