OPIATE PAIN KILLERS & HEART ATTACK RISK
Newly prescribed opioids can cause an early death after heart attacks
Opioid use has been found to exert numerous damaging effects on the heart. Below are the real facts that you need to know about opiate pain killers and heart attack risk.
1. OPIATES SLOW HEART RATE.
Opiates are depressant drugs, which slow down most bodily functions. Therefore, the cardiac effects of opioid use include the slowing of the heart rate (called bradycardia).
2. OPIATES DISRUPT THE HEART’S NORMAL RHYTHM.
It has been found that prolonged opioid use can cause prolonged QT syndrome, which is a defect that impacts the electric function of the heart and in turn, this can disrupt the heart’s normal rhythm.
3. OPIATES CAN CAUSE HEART DAMAGE.
Long-term opioid abuse can cause a permanent delay in heart rhythm and this delay in the heart’s rhythm, can result in heart damage and inadequate oxygen delivery.
4. OPIATES CAN INFECT THE HEART LINING.
There is an increased risk of infection of the heart lining with IV use. Additionally, it has been found that longterm opioid use, by intravenous injection, can increase risk of infection of the heart lining and valves.
5. OPIATES CAN CAUSE HEART PALPITATIONS AND ARRHYTHMIAS.
Concerningly, it has been shown that even short-term opioid use, can disrupt this normal rhythm, causing heart palpitations and arrhythmias. In a recent study, data was collected between 1999 and 2012 from 23,000 patients who had recently been prescribed a long-acting opioid medication. This dataset was compared with an equal number of patients who had been prescribed alternative pain medication, including anticonvulsants and lowdose antidepressants. The results of this research suggest unforeseen heart risks with opiate drugs, during the early days of taking the medication. The important conclusions were as follows:
1. RISK IS GREATER FOR PATIENTS ON NEWLY PRESCRIBED OPIATES.
Patients who have been newly prescribed an opioid painkiller, have a significantly greater risk of early death compared with patients who were prescribed alternative pain medications. Notwithstanding the risk of overdose with powerful opioid drugs, such as Oxycontin and Fentanyl, this new study has uncovered unforeseen heart risks with opiate drugs during the early days of taking the medication.
2. OPIOIDS CAUSE INCREASED RISK DURING SLEEP.
The risk of premature death was found to be related to breathing difficulties during sleep. Specifically, patients who had been
Patients have a greater risk of early death during treatment with a newly prescribed opioid.
newly prescribed opiate medication were reported to have a greater risk of premature death compared with patients who were prescribed different pain medications. Much of this increased risk was found to be related to breathing difficulties during sleep. Nevertheless, the substantial increase in cardiovascular death risk during sleep, is a new finding. Thus, caution must be advised when prescribing opioids for patients who are at higher cardiovascular risk.
3. AN INCREASED RISK OF DEATH, DUE TO NEW HEART COMPLICATIONS.
An important caveat of this study’s results, is that the study focused exclusively on the risks of opiate medication for first-time opioid users. During the average tracking period of approximately five months, there were 185 deaths in the opioid treatment group versus 87 deaths in the alternate pain medication group. The study found that with firsttime opiate treatments, these patients had a 65% increased risk of death due to new heart complications. The study’s authors concluded that alternate pain medications
should be favoured over long-acting opioids whenever possible, particularly for those patients who have a history of heart disease, heart attack or diabetes. According to the investigators who stated, ‘Our opinion, which is consistent with the recent guidelines from the Centres for Disease Control and Prevention, is that opioids should be used as a last resort’.
4. CEASING LONG-TERM USE, SUDDENLY INCREASED THE RISK OF AN ADVERSE EVENT.
The above study focused exclusively on the risks of opiate medication for firsttime opioid users. However, there is a need for more research to assess the risks experienced by patients who are attempting to cease long-term opioid use. Transition can be very difficult among long-term opiate users and suddenly stopping opiate medication after longterm usage can actually increase the risk of some adverse events for some patients. Therefore, before you make any changes to your pain medications, it’s important that you speak with your physician to establish the best course of action for you with opiate pain killers and heart attack risk.
Dr Warrick Bishop is a cardiologist with special interest in cardiovascular disease prevention incorporating imaging, lipids and lifestyle. He is author of the book ‘Have You Planned Your Heart Attack?’, written for patients and doctors about how to live intentionally to reduce cardiovascular risk and save lives! Dr Bishop can be contacted via his website