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Long-Acting Opioid Use & Risk of Infections

Clin Infect Dis; ePub 2018 Sep 15; Wiese, et al

Among long-acting adult opioid users, the risk of serious infections varies by opioid type, a recent study found. The retrospective cohort study included Tennessee Medicaid enrollees aged ≥18 years initiating long-acting opioids from 1995-2015. Hospitalizations for serious infection were identified using validated coding algorithms. Researchers compared the risk of infection among patients using long-acting opioids with known immunosuppressive properties (morphine, fentanyl, methadone) to patients using long-acting opioids without immunosuppressive properties (oxycodone, oxymorphone, tramadol). Users of individual long-acting opioids were also compared to long-acting morphine users. Among the findings:

  • 1,906 serious infections were identified among the 61,240 patients initiating opioids with immunosuppressive properties and 22,811 patients initiating opioids without immunosuppressive properties.
  • Non-immunosuppressive opioid users had a lower rate of infection vs immunosuppressive opioid users.
  • Oxycodone users had a lower rate of infection vs morphine users.


Wiese AD, Griffin MR, Schaffner W, et al. Long-acting opioid use and the risk of serious infections: A retrospective cohort study. [Published online ahead of print September 15, 2018]. Clin Infect Dis. doi:10.1093/cid/ciy809.