A second study published in the same issue of the journal compared opioid painkillers against non-opioid analgesics, and found that patient "adverse events" were more likely when an opioid was taken.
A team led by Dr. Damiel H. Solomon of Brigham and Women's Hospital, Boston, compared the safety of opioids against non-steroidal anti-inflammatory drugs (NSAIDs, which include aspirin, ibuprofen and naproxen) and "coxib" drugs such as Celebrex (celecoxib). They tracked outcomes for almost 13,000 Medicare recipients who took such pain relievers between 1999 and 2005.
The Boston team found that patients on opioids had higher rates of adverse events generally than did people taking an NSAID or a coxib drug. For example, 101 of every 1,000 prescription opioid users suffered a fracture in a given year versus 19 of every 1,000 people taking another type of painkiller. Coxibs and opioids were also associated with a higher risk for cardiac events compared to NSAID use, the team found.
What to do if you're taking an opioid? "There's no question that opioid drugs carry important risks," Portenoy said. "If you have chronic pain, your doctor should optimize the dosing and be managing the risk: not only the risk of side effects and toxicities but also the risk of things like drug abuse."
There's more on painkillers at the U.S. National Library of Medicine .
-- Randy Dotinga
SOURCE: Russell K. Portenoy, M.D., chairman, department of pain medicine and palliative care, Beth Israel Medical Center; New York City; Dec. 13/27, 2010, Archives of Internal Medicine;
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