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Prescribe chronic pain medications for shorter periods of time, researchers advise

Commonly used analgesic drugs significantly impair cardio-metabolic health and obesity and should be used for shorter periods of time, a Newcastle University study has found. 

The research, published in PLOS ONE found that gabapentinoids and opiates doubled the risk of obesity and were associated with increased rates of hypertension and poor sleep.

Scientists assessed the cardio-metabolic (CM) health and sleep patterns of more than 133,000 participants from the UK Biobank.

Body Mass Index, waist circumference and blood pressure were compared between those taking painkillers for chronic, non-cancer pain and cardio-metabolic drugs, compared to those prescribed cardio-metabolic treatment only.

After controlling for the factors which impact upon CM health, the odds of being obese, having a ‘very high risk’ waist measurement and hypertension were significantly increased in those on analgesic medication.

Patients on opiates and cardio-metabolic drugs had the worst CM profile, and were 95% more likely to be obese, 82% more likely to have a 'very high risk’ waist circumference and 63% more likely to have hypertension, as compared to those on cardio-metabolic drugs only.

Those taking neuropathic pain medications and CM drugs also reported a worse CM profile than those taking CM drugs only.

The proportion of patients sleeping less than six hours or more than nine hours a night was higher in the analgesic groups, with those taking combination prescriptions of both neuropathic pain medication and opiates showing the worst sleep.

Dr Sophie Cassidy, lead author and research associate at Newcastle University’s institute of cellular medicine, noted the large increase in opioid and non-opioid prescriptions for pain in last two decades. She said: ‘This is the largest study looking at the links between commonly prescribed painkillers and cardio-metabolic health.

‘We already know that opiates are dependency-forming but this study also found patients taking opiates have the worst health.

‘These results add further weight to calls for these chronic pain medications to be prescribed for shorter periods.’

Study co-author, Dr Kirstie Anderson, honorary senior lecturer at Newcastle University and consultant neurologist at Newcastle Hospitals NHS Foundation Trust, added: ‘There has been recent concern about opioids and a large number of side-effects, including worsening overnight breathing and therefore disturbed sleep.

‘Our study is the largest of its kind to look at this group of drugs and show an association between obesity and poor sleep.

‘Further studies are needed to understand how the drugs may affect metabolism over time.’

This comes as the government is consulting on its plan to reclassify the gabapentinoids as controlled Class C drugs, following a spike in the number of related deaths and series of studies warning about the adverse effects of the medication. 


Readers' comments (3)

  • Dear researchers

    No Sierra Hotel india tango sherlock!
    Did you really have to waste research funds to come up with that!?
    Come and spend a day in the real world

    With love

    Dr C

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  • David Banner

    The clue is in the term "chronic pain". Fine, give them short term opiates/pregabalin, but they will be back, in pain, looking for more. The answer?? BAN these drugs for chronic pain, or at least only initiate and FOLLOW UP in secondary care. A Shared Care protocol similar to methotrexate via rheumatology would be a better model, but it will take a large invstment in Pain Clinic services. But the current system of a Pain Clinic letter cheerfully asking us to titrate up pregabalin/ oxycodone and "the patient is now discharged, it's your problem now old son", is totally unacceptable, reckless and dangerous.

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  • "...calls for these chronic pain medications to be prescribed for shorter periods"

    Agree with David Banner. How is a short term prescription helpful in chronic pain?

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