Long-term use of prescription opioids linked to higher mortality

Taking prescription medications such as Vicodin or Oxycontin for long periods may increase a patient's risk of death from any cause, according to Yale researchers.

A Yale-led team found a strong association between long-term use of prescription opioids, as well as prescription benzodiazepines—a class of drugs often used to treat anxiety and insomnia—and death from all causes in patients. The association was even more pronounced for patients with HIV infection.

Prescriptions for opioids and benzodiazepines alone, and in combination, have been on the rise in recent years. In an earlier study the research team, overseen by professors of medicine Dr. Amy C. Justice and Dr. David A. Fiellin, had previously shown a link between multiple prescriptions and mortality for patients with or without HIV. However, the potential harm of taking opioids and/or benzodiazepines long term—defined as 90 days or more—had not been assessed.

In the current study, the team, led by Dr. Daniel F. Weisberg, found a 40% increased risk of death for patients who received prescription opioids long term. The risk was even greater for patients also taking benzodiazepines and those with HIV infection. The increase in risk associated with long-term benzodiazepine use was 26%.

"A major concern is the issue of overdose that can be seen with opioids and benzodiazepines," said Fiellin. Additional risks of long-term use of these drugs include falls, motor vehicle accidents, and exacerbation of existing medical conditions.

The researchers previously demonstrated that the prescribing of opioids over time has not been consistent with established guidelines, which call for frequent monitoring, urine testing, and alternative therapies. "There's a greater reliance on the medication as opposed to alternatives strategies to address chronic pain," Weisberg noted.

The study published online in the Journal of Acquired Immune Deficiency Syndrome.