New research has found that people who regularly use opioid medications may face a higher risk of developing dementia—especially a type called vascular dementia, which is linked to problems with blood flow to the brain.
The study, published in Alzheimer’s & Dementia, was led by Dr. Sha Feng from the Shenzhen Institute of Advanced Technology in China, along with U.S. researchers Dr. Jed Barash and Professor W. Andrew Kofke.
They looked at nearly 200,000 people in the UK Biobank, all between the ages of 37 and 73, who were living with chronic non-cancer pain. The participants were followed for an average of almost 14 years.
Chronic non-cancer pain, or CNCP, refers to ongoing pain lasting more than three months that isn’t caused by cancer.
Since the 1990s, opioids have been widely used to treat this kind of pain, but growing concerns about overuse, addiction, and long-term health effects have made researchers look more closely at how these drugs affect the body—including the brain.
This new study found that people who regularly took opioids were about 20% more likely to develop dementia than those who used other types of painkillers.
For those taking strong opioids, the risk jumped even higher—by more than 70%. In contrast, people who took non-opioid pain medications had no increased risk.
Using brain scans, the researchers also discovered that people who used strong opioids regularly had smaller brain volumes overall, including in the white matter and hippocampus—areas important for memory and thinking. They also performed worse on tests measuring fluid intelligence, which involves problem-solving and reasoning skills.
The researchers believe that the link between opioid use and dementia could be due to the drugs’ effects on the brain’s natural opioid system and key memory regions like the hippocampus. While this study doesn’t prove that opioids cause dementia, it does suggest a strong connection that deserves more attention—especially as many people with chronic pain depend on these medications.
The findings highlight the importance of being cautious with long-term opioid use, especially strong ones, and exploring other options for managing chronic pain. Understanding the balance between pain relief and long-term brain health will help guide safer treatment choices in the future.