April 17, 2012

expert reaction to new research into opium use and mortality

A study in the British Medical Journal suggested that long term opium use was associated with almost double the risk of death from causes including circulatory diseases, respiratory conditions and cancer.

Professor Donald Singer, member of the British Pharmacological Society, said:

“The key message in this BMJ prospective study on opiates is of interest to pharmacologists, health professionals and members of the public: use of recreational opium, whether raw or modified, smoked or swallowed, appears associated with increased risk of death from a wide range of diseases, including circulatory and respiratory disorders, and cancer.

“However the results need to be interpreted with caution. This work is from north-east Iran and may not be typical for other ethnically or genetically different individuals. The authors note that they cannot be sure whether the relationship is causative. And oddly, risks from opiates did not appear to be amplified in people with high blood pressure, smokers or diabetics, raising some questions about the accuracy of clinical data collection.”

Professor Roger Knaggs, spokesperson on pain management from the Royal Pharmaceutical Society, said:

“Although this study has shown a link between opioids and death it doesn’t prove that opioids are causing these deaths.

“Opioid medicines, such as morphine, are strong painkillers used in the treatment of severe pain. This new study carried out in Iran suggests that people taking opioids may have a higher death rate, however it does not confirm that they are related. It is unclear how many people were prescribed these medicines to treat pain and how many people took for recreational purposes. Only one of the painkillers studied is available in the UK.

“Other research in the US has suggested similar findings for patients prescribed opioid medicines for severe pain, although national data from the UK would suggest that there only a small number of deaths each year directly associated with opioid use. It is important not to stop taking a prescribed opioid painkiller suddenly and if you have any questions or concerns discuss with your doctor or pharmacist.”

‘Opium use and mortality in Golestan Cohort Study: prospective cohort study of 50 000 adults in Iran’ by Malekzadeh et al., published in the BMJ on Tuesday 17th April.