Prescribed Opioids Increase Risk of Pneumonia in Patients With, Without HIV

This is for our providers that treat pain patients.

aking prescribed opioids increases the risk of pneumonia in individuals with and without HIV, according to a study published in JAMA Internal Medicine.

The study reinforces the concern that prescription opioid painkillers have a negative impact on the immune system. It also underscores the need for awareness among opioid prescribers who can take steps to minimise the risk of pneumonia through vaccination and promoting smoking cessation.

Opioids are commonly prescribed to individuals for pain, especially those with HIV. However, there’s evidence that some opioids — including codeine, fentanyl, and morphine — suppress the immune system and limit the body’s ability to fight bacterial infections, such as pneumonia.

To investigate the link between prescribed opioids and pneumonia, E. Jennifer Edelman, MD, Yale School of Medicine, New Haven, Connecticut, and colleagues analysed data from patients enrolled in the Veterans Aging Cohort Study, a national study of individuals who receive care through the Veterans Health Administration (VA). They looked at individuals with and without HIV who were treated at a VA between 2000 and 2012.

The team matched patients hospitalised for pneumonia with similar patients who did not have pneumonia. The researchers looked at length of time patients were taking opioids, as well as dosages and whether the medications had known immunosuppressive properties or not.

The researchers found that patients prescribed medium or high doses of opioid painkillers were at greater risk for pneumonia than those not taking the medications. The risk was compounded if the opioid contained immunosuppressive properties. Individuals with HIV tended to be more likely to develop pneumonia even at low doses of opioids and especially with immunosuppressive opioids.

“We saw that prescription opioids were independently associated with pneumonia requiring hospitalisation,” said Dr. Edelman.

The authors suggested that providers consider prescribing lower doses of opioids or opioids that do not suppress the immune system.