What is the study about?
Despite the fact that opioid medications are commonly used for chronic pain, the scientific evidence suggests that, unless the pain is cancer-related, they only have (at best) very small benefits if taken medium or long-term. We do know however that there are harms if they are taken long-term.
The UK Biobank is a large-scale database containing in-depth genetic and health information from approximately half a million people across Great Britain. We used this information in order to try to understand:
- Which people were regularly using opioids
- How their health was when using opioids, and
- Whether there was any evidence that people using these more regularly were more likely to die during the course of the study
What did we do?
UK Biobank recruited participants from all over Great Britain between 2006-2010 and undertook and in-depth evaluation of their health (including drugs they regularly took), as well as recording information about their lifestyle. We then looked at whether participants died over the next 10 years (up to 2016).
What did we find?
The participants studied were aged 40-69 years, included similar numbers of men and women, and we only considered people who had not previously had a cancer diagnosis. One in twenty people were regularly using opioids. Opioid use was more common at older ages, and was more common in women. Nine out of 10 people using them reported that they had chronic pain. The highest rates of regular use (with about 1 in 9 of this group reporting regular use of opioids) were in people with low household income, who left school before 16 and who lived in areas with high deprivation. Amongst people who told us they could not work because of their poor health, 1 in 3 were regularly taking opioids. The vast majority of people who used opioids told us that they had difficulty sleeping, just over half had experienced a recent major recent life event and they were much more likely than people who did not use opioids to rate their health as “poor”.
When we compared them to people not taking opioids, those taking “weak” opioids were twice as likely and those taking “strong” opioids three times more likely to die over the next ten years. The difference in deaths remained even after we had taken account of differences in age, health and lifestyle between these groups.
What does this mean?
From the above we concluded that regular use of opioids is common in Great Britain, particularly in groups with low income and living in areas of deprivation. Despite the fact that they are mainly used for chronic pain, nearly everyone using them still had chronic pain (and poor health generally). The fact that users were more likely to die over the course of the study, may be due to taking opioids long term, although we couldn’t be certain of this – it could also be due to the underlying reasons they are taking the drugs.
Who funded this work?
This analysis was undertaken through internal funds at the University of Aberdeen.
Where can I read more?
You can read the full scientific paper here.