Opioid users have a significantly increased risk of infections severe enough to require treatment at the hospital, such as pneumonia and meningitis, as compared to people who don't use opioids. The study released in the Annals of Internal Medicine, found that people who use opioids have a 1.62 times higher risk of invasive pneumococcal diseases.
Invasive pneumococcal diseases are serious infections caused by the Streptococcus pneumoniae bacteria, with mortality ranging from 5 to 20%. These invasive diseases include a range of illnesses such as meningitis, bacteremia and invasive pneumonia.
The association between opioid use and the risk of invasive pneumococcal diseases was strongest for opioids used at high doses, those classified as high potency and long-acting, which would be the extended release or controlled release formulations.
The study also found that opioids previously described as immunosuppressive in prior experimental studies conducted in animals had the strongest association with invasive pneumococcal diseases in humans.
The investigators studied Tennessee Medicaid Data to measure daily prescription opioid exposure for each study individual and combined that information with Active Bacterial Core (ABC) surveillance system data to monitor invasive infectious diseases in Tennessee.
A unique feature of the study is the use of laboratory-confirmed infections as study outcomes. The sources of data allowed the team to reconstruct and compare the history of opioid exposures in those subjects with and without invasive pneumococcal diseases.
The increase in opioid use in the U.S. over the past several years has led to an increased interest toward well-known and also previously under-recognized adverse effects associated with opioid use.
Previous studies conducted in animal models had demonstrated that certain opioids can cause immunosuppression and render experimental animals susceptible to infections. However, the clinical implications of those observations in humans were unclear.
The research team indicate that this research provides cautionary evidence of a higher infection risk with prescription opioid use, suggesting the need for prudent steps to protect patients. They further emphasize the need for judicious prescribing of opioids and conclude that opioid prescribing should be consistently cautious and closely monitored among all patients, especially those at increased risk for infections, who may be particularly susceptible to harm. The findings from the study are clinically relevant. Providers should consider these results when making pain management decisions.