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Opioid use may increase risk of pneumococcal infection

In a recent study discussed in the British Medical Journal, researchers investigated the association between pneumococcal infection and the use of opioids.

With the increasing consumption of opioids in North America over the last few decades, greater attention is being brought toward potential risks associated with their use. Opioids are drugs that act on the brain in a similar manner to opium. They are favoured for their pain-relieving properties. Unfortunately, many also come with the risks of addiction, overdose, and cardiovascular complications. Their use has also been associated with an increased risk of infection in animal studies, though their effects on infection in humans are unknown. Understanding the risks associated with opioid use can help clinicians make informed decisions when prescribing opioids such as morphine or oxycodone to patients and when addressing the use of illicit opioids such as heroin or fentanyl.

In a recent article published in the British Medical Journal, the results of a study on opioid use and pneumococcal infection are summarized. The study was conducted in the United States, using 1,233 pneumococcal disease patients and 24,399 healthy controls for comparison. Pneumococcal disease patients were found to be 62% more likely to have had a recent opioid prescription than controls. Moreover, those prescribed opioids in high doses were 72% more likely, those prescribed stronger opioids were 72% more likely, and those prescribed long-acting opioids were 87% more likely to have pneumococcal disease than controls.

Overall, the study found opioid use to be associated with an increased risk of invasive pneumococcal disease. It may therefore be beneficial for clinicians to include the risk of pneumococcal disease among the considerations when prescribing opioids to patients. The researchers suggest that this association may be due in part to the immunosuppressant effects observed in animal studies of some opioids such as morphine or fentanyl. The researchers also note that as opioid use was determined based on patients’ prescriptions, the effect of any illicit opioid use would not have been taken into account.

Written by Raishard Haynes, MBS

Reference: Wise, J. (2018). Opioid use is linked to risk of serious infections. BMJ. doi: https://doi.org/10.1136/bmj.k657

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