Yale study: Opioids raise pneumonia risk, especially in HIV patients

Dr. E. Jennifer Edelman

NEW HAVEN — People who are prescribed opioids to reduce pain are at a greater risk of developing pneumonia, according to study led by researchers at Yale School of Medicine.

The drugs tend to weaken the immune system and are especially risky for patients with HIV, according to a press release. Those who take codeine, fentanyl and morphine are particularly susceptible to being less able to fight off bacterial infections, such as pneumonia, the study found.

The researchers used data recorded between 2000 and 2012 by the Veterans Aging Cohort Study, a national study of those who receive medical care from the Veterans Health Administration, part of the U.S. Department of Veterans Affairs. The patients included those with and without HIV, which weakens the immune system, increasing the risk of opportunistic infections.

“We saw that prescription opioids were independently associated with pneumonia requiring hospitalization,” said Dr. E. Jennifer Edelman , corresponding author and an associate professor at the Yale School of Medicine, in the release.

Prescription opioids may increase the risk of pneumonia by suppressing respiration, mucus secretion and the ability to cough, the release said. The study “lends credence to the hypothesis that opioids have effects on the immune system that are clinically relevant,” Edelman said in the release.

Edelman and her fellow researchers matched patients hospitalized for pneumonia with others who did not have the disease, the release said. The dosages of opioids, length of time the patient was on the drug and whether the opioids had immunosuppressive qualities all were examined.

Patients given medium or high doses of opioids were more likely to develop pneumonia, the study found, especially if the drug had immunosuppressive properties, such as fentanyl, codeine and morphine. Those patients with HIV were at risk of pneumonia even at low doses of the painkillers. According to the release, the study, published in JAMA Internal Medicine, is the first to look at the effect of opioids on HIV-positive patients, the release said.

The authors recommended increased vaccination against pneumonia, urging patients to stop smoking and reducing the dosages or opioids prescribed, the release said.

Connecticut Media Group