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The epidemiology of regular opioid use and its association with mortality: prospective cohort study of 466 486 UK Biobank participants

Published on Apr 1, 2020in EClinicalMedicine
· DOI :10.1016/J.ECLINM.2020.100321
Gary J. Macfarlane81
Estimated H-index: 81
(Aberd.: University of Aberdeen),
Gary J Macfarlane + 1 AuthorsCathy Stannard1
Estimated H-index: 1
Abstract
Abstract Background Opioids have, at most, small benefits for non-cancer pain in the medium and long-term but there is good evidence that they cause harm. The current study describes the characteristics and clinical status of people taking regular opioids in Great Britain and determines whether use is associated with mortality risk. Methods An analysis of participants in UK Biobank, a prospective population-based study. At recruitment (2006–10) participants reported medicines which they regularly used in addition to lifestyle and health-related factors. Information was available on deaths until October 2016. Findings There were 466 486 participants (54% women) aged 40–69 years and without a prior history of cancer of whom 5.5% were regularly using opioids. Use increased with age-group, was more common in females (6.3% v. 4.6%) and 87% of persons using them reported chronic pain. The highest rates of use (~1 in 9) were in people with low household income, who left school Interpretation Regular use of opioids is common in Great Britain, particularly in groups of low socio-economic status. Most users still report chronic pain, poor health generally and are at increased risk of premature death although it is not established that this relationship is causal. Funding There were no external sources of funding obtained for the current analyses.
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  • Citations (1)
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Importance An American Academy of Orthopaedic Surgeons guideline recommends tramadol for patients with knee osteoarthritis, and an American College of Rheumatology guideline conditionally recommends tramadol as first-line therapy for patients with knee osteoarthritis, along with nonsteroidal anti-inflammatory drugs. Objective To examine the association of tramadol prescription with all-cause mortality among patients with osteoarthritis. Design, Setting, and Participants Sequential, propensity sc...
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Summary Background There is a call for greater monitoring of opioid prescribing in the UK, particularly of strong opioids in chronic pain, for which there is little evidence of clinical benefit. We aimed to comprehensively assess trends and variation in opioid prescribing in primary care in England, from 1998 to 2018, and to assess factors associated with high-dose opioid prescribing behaviour in general practices. Methods We did a retrospective database study using open data sources on prescrib...
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Importance Harms and benefits of opioids for chronic noncancer pain remain unclear. Objective To systematically review randomized clinical trials (RCTs) of opioids for chronic noncancer pain. Data Sources and Study Selection The databases of CENTRAL, CINAHL, EMBASE, MEDLINE, AMED, and PsycINFO were searched from inception to April 2018 for RCTs of opioids for chronic noncancer pain vs any nonopioid control. Data Extraction and Synthesis Paired reviewers independently extracted data. The analyses...
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An overreliance on opioids has impacted all types of pain management, making it undoubtedly a root cause of the “epidemic” of prescription opioid abuse in the United States. Yet, an examination of the statistics that led the US Centers for Disease Control and Prevention to declare that prescription
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#1Gary J. Macfarlane (Aberd.: University of Aberdeen)H-Index: 81
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#1Gary J. Macfarlane (Aberd.: University of Aberdeen)H-Index: 81
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Objective The original European League Against Rheumatism recommendations for managing fibromyalgia assessed evidence up to 2005. The paucity of studies meant that most recommendations were ‘expert opinion’. Methods A multidisciplinary group from 12 countries assessed evidence with a focus on systematic reviews and meta-analyses concerned with pharmacological/non-pharmacological management for fibromyalgia. A review, in May 2015, identified eligible publications and key outcomes assessed were pa...
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#### What you need to know Low back pain is the leading cause of long term disability worldwide.1 The lifetime incidence of low back pain is 58-84%,2 and 11% of men and 16% of women have chronic low back pain.3 Back pain accounts for 7% of GP consultations and results in the loss of 4.1 million working days a year.2 More than 30% of people still have clinically significant symptoms after a year after onset of sciatica.4 This guideline replaces the National Institute for Health and Care Excellenc...
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#1Martin C. Gulliford ('KCL': King's College London)H-Index: 55
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