ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Long-acting Opioid Use and the Risk of Serious Infections: A Retrospective Cohort Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 4 of them syntheses that pooled it.
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Who cites it
39 citing papers in PubMed, 4 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- Effectiveness of Interventions for Prevention of Common Infections Among Opioid Users: A Systematic Review of Systematic Reviews.Frontiers in public health · 2022Pooled it
- The Association Between Prescribed Opioid Receipt and Community-Acquired Pneumonia in Adults: a Systematic Review and Meta-analysis.Journal of general internal medicine · 2020Pooled it
- [Recommendations of the second update of the LONTS guidelines : Long-term opioid therapy for chronic noncancer pain].Schmerz (Berlin, Germany) · 2020Pooled it
- Polypharmacy among COVID-19 patients: A systematic review.Journal of the American Pharmacists Association : JAPhAPooled it
- Comparison of the effects of esketamine/midazolam and remifentanil/midazolam on respiratory mechanics in mechanically ventilated patients with acute respiratory distress syndrome.BMC anesthesiology · 2025Trial
- Problem opioid use and HIV primary care engagement among hospitalized people who use drugs and/or alcohol.Addiction science & clinical practice · 2020Trial
- Migraines as a Risk Factor for Many 90-Day Postoperative Complications Following Single-Level Anterior Cervical Diskectomy and Fusion.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025Article
- De-prescribing opioids among Medicaid patients with long-term opioid use.Journal of substance use and addiction treatment · 2025Article
- The Clinical and Molecular Characteristics of Community-AssociatedOpen forum infectious diseases · 2025Article
- Opioid analgesic and antidepressant use during pregnancy and the risk of spontaneous preterm birth: A nested case-control study.Paediatric and perinatal epidemiology · 2025Article
- Risk of infections among persons treated with opioids for chronic pain: a systematic review and meta-analysis protocol.BMJ open · 2024Article
- Risk of Death at 1 Year Following Postpartum Opioid Exposure.American journal of perinatology · 2024Article
- Opioids and Immunosuppression: Clinical Evidence, Mechanisms of Action, and Potential Therapies.Palliative medicine reports · 2024Article
- Reductions in All-Cause Mortality Associated with the Use of Methylnaltrexone for Opioid-Induced Bowel Disorders: A Pooled Analysis.Pain medicine (Malden, Mass.) · 2023Article
- Virally Suppressed People Living with HIV Who Use Opioids Have Diminished Latency Reversal.Viruses · 2023Article
- Frailty and postoperative urinary tract infection.BMC geriatrics · 2022Article
- Characterizing safer supply prescribing of immediate release hydromorphone for individuals with opioid use disorder across Ontario, Canada.The International journal on drug policy · 2022Article
- Less Well-Known Consequences of the Long-Term Use of Opioid Analgesics: A Comprehensive Literature Review.Drug design, development and therapy · 2022Review
- Acute pain and self-directed discharge among hospitalized patients with opioid-related diagnoses: a cohort study.Harm reduction journal · 2021Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundAlthough evidence from animal and human studies indicates opioid analgesics increase susceptibility to infections, it is unclear whether the risk varies by specific opioid. We compared the risk of serious infection among patients initiating long-acting opioid analgesics with and without previously reported immunosuppressive properties.
methodsWe conducted a retrospective cohort study of Tennessee Medicaid enrollees age ≥18 years initiating long-acting opioids (1995-2015). Hospitalizations for serious infection were identified using validated coding algorithms. We used multivariable Poisson regression models to calculate adjusted incidence rate ratios (aIRR) and 95% confidence intervals (CI) to compare the infection risk among patients using long-acting opioids with known immunosuppressive properties (morphine, fentanyl, methadone) to the infection risk among patients using long-acting opioids without known immunosuppressive properties (oxycodone, oxymorphone, tramadol) accounting for demographics, opioid dose, comorbidities and pain conditions, medication use, frailty indicators, and healthcare encounter history using exposure propensity scores. We further compared users of individual long-acting opioids to long-acting morphine users (considered the prototypical immunosuppressive opioid).
resultsAmong the 61 240 patients initiating opioids with immunosuppressive properties and 22 811 patients initiating opioids without immunosuppressive properties, we identified 1906 serious infections. Nonimmunosuppressive opioid users had a lower rate of infections than immunosuppressive opioid users (aIRR:0.78 [CI: 0.66-0.91]). Among individual opioids, oxycodone users had a lower rate of infection than morphine users (aIRR:0.73 [CI: 0.60-0.89]). There were no significant differences in the infection risk between other opioids and morphine.
conclusionThe risk of serious infections among long-acting opioid users varies by opioid type. Providers should carefully consider the risk of serious infections when making pain management decisions.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.