A large-scale international study has found that strong opioids prescribed for pain management carry higher risks, including a higher chance of death, compared to milder opioids like codeine.
Conducted by researchers from The University of Manchester in the UK and McGill University in Canada, the study analyzed data from over 1 million patients across the United Kingdom, United States, and Canada, providing valuable insights into opioid safety.
The study, set to be published in the journal Pain, revealed that patients taking strong opioids, such as morphine, fentanyl, and oxycodone, face a higher risk of death compared to those prescribed codeine.
Among patients taking strong opioids, the risk increased even more for those on higher doses, specifically doses equivalent to 50 or more milligrams of morphine per day.
Morphine milligram equivalents (MMEs) are a standard way to compare the strength of different opioids, making it easier for doctors to understand how much opioid a patient is consuming regardless of the specific medication.
The research findings were consistent across all three countries. In the UK, patients on morphine had over 12 times the risk of death compared to those on codeine, even after taking into account other factors that might influence this risk.
Similar patterns were observed in the U.S. and Canada, with increased risks also found in patients taking other strong opioids, such as fentanyl and oxycodone.
The study also found that certain conditions and medications could increase the risk even further. Patients with a history of depression or substance abuse faced a higher chance of death while on strong opioids.
Additionally, in the UK, patients who were simultaneously taking antipsychotics or benzodiazepines, medications often prescribed for mental health conditions, had an increased risk of death when combined with opioids.
Patients prescribed multiple types of opioids at once were also found to be at a significantly higher risk.
Lead researcher Dr. Meghna Jani, from The University of Manchester, highlighted that while opioids are sometimes necessary for managing pain, particularly in the short term, this research provides valuable information for making safer choices about pain relief options.
By understanding the risks associated with specific opioids, patients and healthcare providers can make more informed decisions.
For instance, the study emphasizes the importance of closely monitoring patients who are taking doses equivalent to 50 milligrams of morphine or more each day, as this dose appears to be a critical threshold where risks can begin to outweigh benefits.
Dr. Jani also stressed the importance of early, open discussions between patients and healthcare providers, especially for those on high doses of strong opioids or with additional risk factors.
Instead of stopping strong opioids suddenly, she advocates for shared decision-making, where both the patient’s needs and safety are taken into consideration. This collaborative approach may involve exploring alternative treatments and providing extra support for patients at higher risk.
In conclusion, this study underscores the need for careful monitoring and informed choices when prescribing strong opioids for non-cancer pain.
By understanding the potential risks and working closely with healthcare providers, patients can make safer decisions and consider alternative pain relief options where appropriate.
This approach could help reduce the potential harms associated with strong opioid use, especially for those at greater risk due to high doses or other health conditions.
If you care about pain, please read studies about how to manage your back pain, and Krill oil could improve muscle health in older people.
For more information about pain, please see recent studies about how to live pain-free with arthritis, and results showing common native American plant may help reduce diarrhea and pain.
The research findings can be found in Pain.
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