The Serious Cardiovascular Side Effects of Opioid Use

As the opioid epidemic rages on, the dangers of opioid use are becoming more apparent to researchers and medical professionals who are finding fatal heart risks associated with opioid use.

The number of opioid prescriptions written has quadrupled over the past decade. More than 250 million opioid prescriptions were written in 2012; enough for every adult in America to have their own bottle of prescription pain pills. For some, opioids are a solution to chronic or acute pain conditions. For others, a prescription for pain medication is the first step down a road towards addiction or worse. Before you make the decision to use opioids, it’s important to understand the side effects of these powerful drugs.

As the opioid epidemic rages on, the dangers of opioid use are becoming more apparent to researchers and medical professionals who are finding fatal heart risks associated with opioid use.

This article was updated on February 5, 2019.

Cardiovascular Death May be More Prevalent than Overdose Deaths

Researchers at Vanderbilt University found that people who take opioids for chronic pain are far more likely to die from cardiovascular or respiratory problems then they are from accidental overdose.

They found that over twice as many opioid-receiving patients died from cardiovascular or respiratory problems than overdose.

“The increased risk of cardiovascular death could be related to adverse respiratory effects of long-acting opioids. Opioids can cause or exacerbate sleep-disordered breathing, including both obstructive and central sleep apnea,” said lead study author Wayne Ray, PhD, of the Vanderbilt University School of Medicine.

Dr. Ray went on to warn that previous research on opioid mortality may have substantially underestimated the true risk of opioids by misclassifying patient deaths as unintentional overdoses.

Opioids May Increase Risk of AFib and Heart Attack

Taking opioids may increase your risk of developing an irregular and often rapid heartbeat, a condition known as atrial fibrillation, or AFib.

AFib is an often symptomless condition where the heart’s upper chambers beat out of sync with the lower chambers. When symptoms do appear, they can include shortness of breath, fatigue, and heart palpitations. Researchers have found that AFib can increase the overall risk of a heart attack by 63%, with a higher rate of risk for women.

In a study published in JAMA Internal Medicine, researchers found a higher prevalence of AFib in opioid users compared to non-users. The researchers also noted an increase in both opioid use and cases of atrial fibrillation in the United States over the past decade and recommended more research be done on the connection between the two.

Opioids + Benzodiazepines: a RX for Heart Danger

Opioid use can be associated with decreased cardiac function when administered in combination with other prescription medications, especially benzodiazepines.

Benzodiazepines are a type of sedative commonly prescribed to treat anxiety or insomnia. Commonly prescribed benzodiazepines include diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin).

More than 30% of opioid overdoses also involve benzodiazepines.

According to a study published in The Ochsner Journal, severe adverse side effects can occur when benzodiazepines are combined with opioids. Both cardiovascular and respiratory risks are enhanced dramatically when the two drugs combine.

Heroin Use Associated with Fatal Heart Infection

Hospitalizations for a heart valve infection often attributed to intravenous drug have increased significantly, according to a new study by researchers from Tufts Medical Center and Tufts University School of Medicine.

Infective endocarditis (IE) is an infection of the heart valve that can be lethal and is often triggered by intravenous drug use, which can introduce bacteria into the bloodstream. In 2000, 7% of all IE cases were related to injection drug use. By 2013, that figure had jumped to 12% - from approximately 3,578 cases to 8,530.

The groups who saw the largest increase in IE were white young adults, ages 15 - 34, and women.

“We’re seeing a shift toward youth, white youth, and women, and it’s likely that we’ll continue to see even higher increases. It’s a much more suburban problem than most people realize,” said senior author Thomas Stopka, PhD, assistant professor of public health and community medicine at Tufts University School of Medicine. Stopka specializes in the epidemiology and geospatial distribution of infectious diseases and substance abuse.

Heroin use has increased five-fold in the last decade amidst the nation’s devastating opioid epidemic.“Over the past decade, we have found a significant increase in heroin use across almost all demographic groups,” said Dr Christopher M Jones, senior adviser at the Food and Drug Administration (FDA).

This increase in heroin use is closely tied to the increase in prescription pain reliever abuse.

Researchers have found a strong positive relationship between heroin and prescription painkiller abuse; as more people become addicted to opiates, either prescription pills or heroin, you see more use of the other.

“Recent CDC research has identified increasing injection drug use - tied to the US opioid epidemic - in rural and suburban areas across the country,” said CDC division director Dr. John Ward.

Medical professionals are also seeing an increase in other intravenous drug-use related diseases as the opioid epidemic rages; new hepatitis C infections tripled between 2010 and 2015 and the Indiana State Health Department reported an HIV outbreak resulting from intravenous opioid use in 2015.

More than 30% of Americans are affected by acute or chronic pain conditions, and many turn to opioids for relief. The side effects of opioid use, however, can be grave. Opioids can result in mild to severe side effects – like the increases in cardiovascular disease mentioned here.

This post is the second part of our series about the serious side effects of long-term opioid use.

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