Older Adults With COPD At Increased Mortality Risk From Opioid Painkillers
According to a Canadian study, adults with COPD (chronic obstructive pulmonary disease) who take opiod painkillers for incident pain are a greater risk for respiratory-related fatalities than those who do not.
Incident pain is immediate pain brought on by movement or activity, such as dressing changes, coughing, etc.
Researchers at the University of Toronto and S. Michael’s Hospital (Toronto) analyzed data from nearly 131,000 persons over the age 66 with COPD.
The patients were treated in Ontario during a five-year period from April 1, 2007 to April 31, 2012. Data was collected from the Institute for Clinical Evaluative Sciences in Toronto.
Findings reveal that those who took opioid painkillers associated with incident pain were at significantly increased risk for ER visits for COPD or pneumonia.
In addition, opioid use was also associated with a significant increase in mortality risk. including pneumonia-related mortality. Opioid users were compared to non-opioid users living in the community.
The study was published in the European Respiratory Journal. The study may be the first to relay a relationship between the use of opioid painkillers, and mortality from respiratory-related causes in COPD patients.
According to the study:
“The fact that incident opioids are frequently initiated in older adults with COPD makes these results particularly worrisome. Our findings suggest that a careful, individualized approach needs to be taken when administering opioids to older adults with COPD…”
And this is true regardless of the opioid dose:
“…adverse outcomes were observed to occur also among new users of lower dose opioids, potentially refuting that such lower opioid doses are indeed safe from a respiratory perspective.”
Use of opioid painkillers is fairly common for older patients with COPD. They are often prescription for musculoskeletal pain and refractory respiratory symptoms.
Researchers stated that mechanisms of involvement may include respiratory depression, immunosuppression, and cough suppression resulting in reduced mucous clearance.
The study received funding from the Lung Association-Canadian Thoracic Society and the Institute for Clinical Evaluative Sciences.
~ G. Nathalee Serrels, M.A., Psychology