The dangers of opioid medications like oxycodone, hydromorphone and morphine are becoming more and more well known thanks to countless studies, but it would seem that men are at a higher risk than women for death as a result of chronic use of these types of medications for non-cancer related conditions as well as short-term and long-term injuries. The study was conducted by the Institute for Clinical Evaluative Sciences (ICES) and the results showed that one in 45 men ramped up their dose to 200 milligrams of morphine or it’s equivalent, whereas one in 70 women did the same. The study indicated that for those people who elevated their dose in such a way were 24 times more likely to die from complications related to the medications versus those who did not increase their dose in such a way.
“This is really the first large-scale study to give us an idea of how likely it is that patients who are receiving chronic opioid therapy will die from their treatment,” said Juurlink. “And as somebody who has been quite critical of these drugs over the years, the findings surprise even me.”
The 1997-2010 study, which examined health records for more than 285,500 Ontarians aged 15 to 64, found that more than one in every 10 patients prescribed the drugs for the first time became chronic users.
As well, one in every 350 men and one in every 850 women died as a result of taking an opioid long-term.
“One in 350 doesn’t sound especially high, but remember there are tens of millions of patients on these drugs, and we’re talking about death,” said Juurlink. “So from a public health perspective, that’s a very big deal.”
An interesting note to this is that women are more likely to be prescribed opioid medications, but men are more likely to be prescribed a higher dose. Dr. Juurlink believes that doctors, for whatever reason, feel more at ease with prescribing higher doses of these powerful medications to men, but he warns that because of this practice men are going to hit that “threshold” of too much medicine more quickly, which can have very serious ramifications on their health.
This study was conducted between 1997 and 2010, before new guidelines in Canada had been introduced to prevent the potential over-prescribing of these types of medications. Doctors and researchers involved in the study wanted it known that new studies will be vital in determining the effect the new guidelines are having, but that doctors should, when possible, avoid prescribing these types of medications as the potential for misuse are high.
Doctors have taken a lion’s share of the blame on this issue for years now, and some of the blame does lie with them, but as doctors exist primarily to help us lead healthy lives that allow us content and joy, it is difficult for them not to try and help us the best ways they know how. And despite their intimate knowledge of science, anatomy and biology they often have to listen to what we have to say when it comes to our physical pain. A notoriously difficult thing to diagnose and manage. As we learn more about these types of medications and more studies are conducted, hopefully doctors will be able to handle the burden of treating chronic and acute pain with more certainty. Not to mention, as Canadians we are lucky to have excellent medical researchers who may in the near future find better ways to diagnose and treat certain conditions that we have previously relied on pain medication to “fix”.