Opioids may up mortality in elderly with lung disease

Toronto: Older adults who are new users of opioids and are already suffering with lung disease are at more than two-fold higher risk of dying from a respiratory-related complication compared to non-opioid users, says a research. Chronic obstructive pulmonary disease (COPD) is a progressive lung disease that causes difficulty in breathing. The findings showed that the risk for respiratory-related death was five times higher for new opioid users compared to non-opioid users. To lower the risks of adverse events, the thinking has been to prescribe less potent or lower dosage opioids.  However, a significant risk of respiratory-related complications and death in new opioid users were found regardless of the dose, the researchers said.  "This is an important finding because it has been previously thought that lower opioid doses might be safe for COPD patients," said lead author Nicholas Vozoris, Respirologist at St. Michael's Hospital in Ontario, Canada. Opioids like morphine are prescribed frequently among older adults with COPD to help treat chronic muscle and bone pain, persisting cough and shortness of breath despite inhaler therapy, as well as insomnia. "This class of drugs may offer some relief, however, there is also evidence suggesting that opioids can adversely affect breathing and lung health in people who already have chronically compromised lungs," Vozoris added. "Our findings show there are not only increased risks for respiratory-related death associated with new opioid use, but also increased risk of visits to emergency rooms, hospitalisations and needing antibiotics or steroid pills," he said. Previous studies have shown about three-quarters of older adults with COPD have been prescribed opioids.  "Sometimes patients are looking for a quick fix for chronic pain or breathing issues," Vozoris noted.  The doctors should explain to patients that potentially alleviating their symptoms could come at a higher cost to their health, the researchers said adding that the evidences does not support the use of opioids even for chronic pain. For the study, published in the European Respiratory Journal, the team looked at the records of more than 1,30,000 adults in Ontario with an average age of 66 and older with COPD.