Do you routinely take an opioid pain reliever for your bad back or some other work-related injury? If so, accidental overdose and addiction may not be the only risks you need to be concerned about.

New research from the Vanderbilt University School of Medicine indicates regular use of prescription opioids increases risk for heart attack and other cardiovascular events. Among more than 45,000 patients, those taking opioid painkillers had a 64 percent higher risk of heart-related death within six months of starting treatment compared to patients taking non-narcotic prescription alternatives. These alternatives included anticonvulsants and antidepressants, which have been used to treat certain types of pain.

“Because most patient populations have more cardiovascular deaths than overdose deaths, our finding means that prior studies may have underestimated the harms of long-acting opioids,” said study author Wayne Ray, a health policy professor at Vanderbilt.

Deaths linked to opioids reached an all-time high in 2014 when more than 18,000 people died from overdoses. However, the Vanderbilt study indicates that the true figure is considerably higher.

“As bad as people think the problem of opioid use is, it’s probably worse,” said Ray. “They should be a last resort and particular care should be exercised for patients who are at cardiovascular risk.”

Do You Have a Respiratory Condition?

Keep Your Workplace Safe with Help from the LHSFNA

Drug-free workplace policies and programs can help protect employers and employees from the consequences of alcohol abuse, illegal drugs and the misuse of prescription pain relievers and other medications.

The LHSFNA’s Health Promotion Division can help develop, review and tailor drug-free workplace policies and programs to the unique needs and challenges of specific workplaces. For more information, call 202-628-5465. Pamphlets, booklets and other materials about substance use disorder and drug-free workplace programs can be ordered through the LHSFNA’s website at www.lhsfna.org by clicking on Publications.

In addition to increased cardiovascular risk, people affected by respiratory conditions such as sleep apnea or COPD should also use caution when taking opioids. One side effect of opioid use is respiratory depression, which occurs when the body stops getting the signal to breathe. This can be especially dangerous when breathing is less frequent, such as during sleep.

If you have a respiratory condition such as sleep apnea or COPD, tell your health care provider before you are prescribed an opioid.

What Is Sleep Apnea?

People with sleep apnea periodically stop and restart breathing. This cycle repeats itself hundreds of times in a night and is characterized by loud snoring and intervals of silence when breathing has stopped. These pauses can last 10 seconds or longer, putting an enormous stress on the heart. Sleep apnea increases risk for high blood pressure, heart attack, heart failure and stroke.

Sleep apnea affects an estimated 18 million Americans, many of whom are unaware. Being overweight increases risk but it can develop in anyone.

What Is Chronic Obstructive Pulmonary Disease (COPD)?

COPD is an umbrella term for incurable respiratory diseases like chronic bronchitis and emphysema that gradually make it difficult to breathe. Twenty-four million people in the United States are believed to have COPD, but half don’t know it. Smoking and occupational exposures in construction are the top causes.

Inflammation from COPD leads to coughing, wheezing and shortness of breath and increases risk for heart attack and other cardiovascular conditions. COPD is a leading cause of death in the U.S. Only heart disease and cancer claim more victims.

Make sure all of your health care providers know if you have pre-existing conditions. This information could affect treatment decisions, including whether or not you are prescribed an opioid.

[Janet Lubman Rathner]