America’s ongoing opioid crisis is no secret. With thousands dying from prescription painkiller overdoses each year — nearly as many as traffic deaths — even the U.S. government has been forced to take action. As awareness of the epidemic continues to grow, further hazards of the pharmaceutical class of drugs are being revealed — including potentially higher numbers of deaths caused by their use.
According to a recent report from CBS, opioids are often the factor in deaths caused by infections like pneumonia. CDC field officer Victoria Hall explained that “Opioid medications — codeine, hydrocodone (including Vicoprofen), oxycodone (Oxycontin, Percocet), morphine and others” can cause respiratory complications.
“Opioids at therapeutic or higher than therapeutic levels can impact our immune system, actually make your immune system less effective at fighting off illness,” she said, adding that because opioids are sedatives, they can cause breathing to become slower and more shallow, which makes the person less likely to cough. Hall says this makes “it easier for something like a pneumonia to really set in.”
Complicating matters, Hall found in a recent analysis that when individuals die of an infection worsened by opiate abuse, the cause of death listed on their death certificate often only cites the infection — not the drugs. She presented her findings at a CDC meeting this week.
Hall and a colleague reviewed Minnesota’s unexplained death database and found 59 cases where opioids were involved. Twenty-two of those cases were not reported to the state’s opioid surveillance because “the involvement of drugs hadn’t been listed on the death certificate,” CBS noted.“We found if you have [a] really profound infectious disease, like really bad pneumonia, that may be the only thing written on the death certificate,” she said. “And thus it’s not going to get picked up in opioid surveillance.”
Still, “[p]neumonia was listed as a cause of death in 54 percent of the unexplained drug-related cases, the researchers found.”
In one example, a Minnesota man who had been abusing opiates eventually died from a bout of the flu brought on by pneumonia.
“He was on long-term opioid therapy for some back pain, and his family was a little bit concerned he was abusing his medications,” Hall said, also noting that though the main cause of death the flu, he had a “very toxic level of opioids in his system.”
“[O]n the death certificate it only listed the pneumonia, and it listed no mention of opioids, so this death wasn’t counted in the state opioid death surveillance system,” she said.
Pneumonia was listed as a cause of death in 54 percent of the unexplained drug-related cases, the researchers found. Hall said this could have profound implications for keeping track of opiate deaths, particularly in states hit hard by the opioid crisis.
Her concerns about complications from opioids were confirmed by Dr. Robert Glatter, an emergency room doctor at New York’s Lenox Hill Hospital. He said they “see a fair number of patients who use opiates. And in those patients we see, in general, a higher risk profile for developing pneumonia and other respiratory illness.”
As the extent of the nation’s opioid problems continues to come to light, Glatter issued a simple observation:
“This is another in a sequence of reasons to not use opiates.”