In comparison with non-opioid analgesics, opioids may give way to an increased all-cause mortality risk, as culminated from a systematic review in ‘European Journal of Pain’.

Amongst the many complications associated with the use of opioids, risk of increased mortality is of particular and thus has been explored in this study in chronic non cancer pain (CNCP).

Thomas Tölle and reaserchers conducted a systematic review of propensity score corresponding observational studies assessing the mortality linked with opioid and non-opioid analgesics. Database searching included exploring Scopus, Clinicaltrials.gov, Google Scholar and MEDLINE. The pooled adjusted hazard ratio (aHR) of all-cause mortality was regarded as the primary outcome.

On the whole, 120 186 patients in 4 studies with seven study arms were evaluated. The pooled aHR for all-cause death and mortality risk limited to out-of-hospital deaths was 1.69 (95% confidence interval [CI] 1.47, 1.95) and 2.12 (95% CI 1.46, 3.09), respectively. Cardiovascular death was the most common cause of mortality. Older patients with more somatic diseases used opioids than non-opioids.

The most likely risks of increased all-cause mortality with opioids usage should be discussed prior to considering the treatment options for CNCP patients, suggested the study researchers.