Opioid use may provide relief for older people with chronic obstructive pulmonary disorder (COPD), but the cons seem to outway the pros, says respirologist Dr. Nicholas Vozoris. A new study led to the discovery that opioid use in older COPD patients leads to an increased risk of death due to coronary artery disease.
A dangerously large number older adults with COPD are using opioids considering the findings of this study, Vozoris said. "Previous research has shown about 70 percent of older adults with COPD use opioids, which is an incredibly high rate of new use in a population that is potentially more sensitive to narcotics.” Vozoris is the lead author of the new study published in the European Journal of Clinical Pharmacology.
Vozoris and his team of researchers examined opioid use in older adults with COPD - more than 130,000 adults living at home and 14,000 living in the hospital on a long-term basis - all at least 66 years old. They found that opioid use increases a person’s risk of coronary artery disease-related death by 215 percent for long-term hospital residents and 83 percent for adults living at home.
Opioids, including morphine and fentanyl, are prescribed to alleviate chronic pain, insomnia, and respiratory problems in COPD patients. Aside from raising the risk of coronary artery disease, opioid use in COPD patients also increases the risk of dying from respiratory problems.
Despite their therapeutic impact, opioids increase risk of disease because they lower blood oxygen levels, increase blood carbon dioxide levels, and sometimes increase inflammatory factors in the blood vessels that promote blood clot formation that raises the risk of heart attack.
"One other important reason they might be linked to future risk of heart attacks is because they offer pain relief, which could reduce or take away chest pain that acts as a warning before a cardiac event," Vozoris said. "Without that warning, doctors may not be able to intervene in time."
Vozoris’s goal is to make doctors and patients aware of the risks of opioid use in the context of old age and COPD. "I hope that providers will be more careful about prescribing opioids to COPD patients, and that patients are made aware of the risks so they can be vigilant about potential side effects."
The present study was published in the European Journal of Clinical Pharmacology.
Source: St. Michael’s Hospital