Opioid use linked to more fractures and even death among elderly patients

Opioid use linked to more fractures and even death among elderly patients

Elderly patients with arthritis who regularly take opioids for pain experience more undesirable and sometimes dangerous side effects than those on other painkillers, such as Coxibs and NSAIDs (non-steroidal anti-inflammatory drugs), researchers from Brigham and Women's Hospital, Boston, reveal in Archives of Internal Medicine.

Opioids are a class of drugs commonly prescribed for their painkilling (analgesic) properties. They include substances such as codeine,oxycodone, methadone, or morphine. They may be more easily recognized by the brand names, such as OxyContin,Kadian, Demerol, Percocet, Avinza, Percodan, Darvon, , Vicodin, and Lomotil.

The authors wrote:

"In the United States, one in five adults received a prescription for an analgesic in 2006, accounting for 230 million prescription purchases; however, the comparative safety of these drugs is unclear. Although the cardiovascular safety of nonselective nonsteroidal anti-inflammatory drugs (nsNSAIDs) and selective cyclooxygenase-2 inhibitors (coxibs) has been called into question, there is little comparable information about the third major analgesic group, opioids."

Daniel H. Solomon, M.D., M.P.H., at Brigham and Women's Hospital, Boston and team set out to compare the safety of opioids, Coxibs and NSAIDs among 12,840 Medicare beneficiaries. They had all been given one or more of these painkillers between 1999 and 2005. By gathering data from an extensive claims database, the researchers worked out how many of them developed heart attacks, stroke, heart failure, gastrointestinal tract bleeding, bowel obstruction, liver toxicity, acute kidney injuries, and bone fractures.

They found that patients on opioids had a higher risk of experiencing adverse events compared to those on NSAIDs or Coxibs. Those on NSAIDs had the lowest risk.

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