Study confirms increased pneumonia risk with prescription opioids

A study led by researchers at Yale University has shown that taking prescribed opioids increases the risk of pneumonia irrespective of HIV status.

Picture of prescription medicine pills - example of opioid medication by Wollertz

Wollertz | Shutterstock

Opioids are commonly prescribed as a painkiller, particularly for people with HIV. However, evidence suggests that some opioids suppress the immune system and restrict the body’s defense against bacterial infections such as pneumonia.

Now, Dr. Jennifer Edelman and team have reinforced this concern by examining the impact of prescription opioids on pneumonia risk in HIV and non-HIV infected patients. The authors say that to their knowledge, this is the first study to test this association.

As reported in the journal JAMA Internal Medicine, Edelman and colleagues studied data available for patients enrolled in the Veterans Aging cohort Study who were treated at a Veterans Health Administration between 2000 and 2012. Patients with and without HIV who were hospitalized for pneumonia were matched with similar patients who did not have pneumonia.

The team looked at the duration of opioid prescription, dosages and whether the medications possessed known immunosuppressive properties.

The researchers report that patients who were prescribed medium or high doses of opioids were at an increased risk for pneumonia, compared with those who were not taking opioids. This risk was increased further if the opioid prescribed had immunosuppressive properties.

Participants who had HIV were at a grater risk of developing pneumonia even when opioid dose was low and particularly in the case of immunosuppressive opioids.

"We saw that prescription opioids were independently associated with pneumonia requiring hospitalization," says Edelman.

The team says prescription opioids can affect the body’s ability to defend against pneumonia in various ways, by suppressing cough, breathing and the secretion of mucus. The study "lends credence to the hypothesis that opioids have effects on the immune system that are clinically relevant," says Edelman.

The finding highlights the need for awareness among healthcare providers who can takes steps to limit the risk of pneumonia. For example, healthcare professionals could consider prescribing lower doses of opioids or opioids that do not suppress the immune system. They could also be proactive about encouraging patients, particularly those with HIV, to get vaccinated against pneumonia.

Sally Robertson

Written by

Sally Robertson

Sally has a Bachelor's Degree in Biomedical Sciences (B.Sc.). She is a specialist in reviewing and summarising the latest findings across all areas of medicine covered in major, high-impact, world-leading international medical journals, international press conferences and bulletins from governmental agencies and regulatory bodies. At News-Medical, Sally generates daily news features, life science articles and interview coverage.

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