Long-acting Opioids Increase Cardiovascular Deaths in Noncancer Patients

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Long-acting opioids increased the risk of all-cause mortality in patients with chronic noncancer pain, based on 22,912 new episodes of long-acting opioid prescription and an equal number of control prescriptions during an average follow-up of 176 days and 128 days respectively.

In the follow-up period, 185 people given long-acting opioids and 87 in the control group died. The hazard ratio for total mortality in the opioid group was 1.64, according to Wayne Ray, Ph.D., of Vanderbilt University, Nashville, and his associates.

Out-of-hospital deaths accounted for 154 deaths in the opioid group and 60 in the control group, with a hazard ratio of 1.9. The hazard ratio in the opioid group for out-of-hospital deaths other than unintentional overdose was 1.72. Cardiovascular events were the most common cause of death, accounting for 79 deaths in the opioid group and for 53 deaths in the control group. The hazard ratio for cardiovascular death was 1.65.

“The study finding that prescription of long-acting opioids was associated with increased cardiovascular and other nonoverdose mortality adds to the already considerable known harms of the opioids and thus should be considered when assessing the benefits and harms of medications for chronic pain,” the investigators noted.

Find the full study in JAMA (doi: 10.1001/jama.2016.7789).

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