New research published tonight in Annals of Internal Medicine offers insight into two hot-button issues in regard to our nation’s public health: Opioids and e-cigarettes.
In one study, researchers showed an association between opioid use and pneumococcal infections.
“Researchers from The Vanderbilt University Medical Center used data from the Tennessee Medicaid database linked to Medicare and Active Bacterial Core surveillance system databases to test the hypothesis that prescription opioid use is an independent risk factor for invasive pneumococcal disease,” Annals reported. “They found a significant association between opioid use and the risk of laboratory-confirmed invasive pneumococcal diseases, and that this association was strongest for opioids used at high doses, those classified as high potency and long-acting formulations.
“The data also showed that opioids previously described as immunosuppressive in prior experimental studies conducted in animals had the strongest association with invasive pneumococcal diseases in humans.
“According to the researchers, providers should consider these findings when discussing pain management with their patients.”
In an accompanying editorial, a Kaiser Permanente doctor shows how the elderly may be most at risk as it pertains to the research conclusion.
She ends with a stern warning:
“While awaiting more definitive answers, we must reconsider the risks and benefits of opioids. The current widespread use of these drugs in the United States is not based on adequate research establishing either their effectiveness or their safety. Reflexive and poorly monitored prescribing of opioid analgesics on the untested assumption that patient outcomes are improved may be harming more patients than we care to admit….
“Cautious prescribing should not be limited to patients deemed at increased risk for drug addiction or overdose. Before prescribing an opioid, the clinician should carefully consider all reasonable alternative approaches to pain relief. It now seems that decision making also should take into account the risk for serious infections.”
E-cigarettes: Better than the stinky kind? Perhaps
In a second research letter, Dr. Nancy Rigotti warns Americans not to overestimate the benefits to your health of e-cigarettes.
It is a painstaking explanation undertaken by a doctor whose concluding statement illustrates true to service to patient:
“My approach is as follows: I tell patients that using e-cigarettes is less harmful than continuing to smoke cigarettes, but because e-cigarettes are so new, I caution them that many questions about their long-term safety remain unanswered. As first-line treatment, I recommend FDA-approved smoking cessation aids with established safety and efficacy. If smokers want to try e-cigarettes, I recommend switching completely and avoiding flavored e-cigarettes.
“I encourage smokers who switch to e-cigarettes to eventually quit using e-cigarettes too because of uncertainty regarding their long-term safety. To avoid exposing others to chemicals in the e-cigarette aerosol, I advise users not to vape indoors or around children. Overall, the message I aim to convey is that I will continue to support and assist patients on their journey to becoming nonsmokers.”
E-cigarettes and opioids both are topics I have written a ton about. I know both of these health trends affect just about everyone in one way or another.
Until next time.