Significant Rates of Opioid Use for Pain Symptom Management among People with Lupus
Research published today sheds light on concerning data: study participants with lupus were three times more likely to have used opioids compared to those without the disease. Researchers found that nearly one third (31%) of the participants with lupus used prescription opioids during a 20-month study compared to just 8% of control subjects. Among the people with lupus using these prescription drugs, nearly 70% were using them for more than a year, and more than one-in-five were taking two or more opioids at a time.
Additionally, the study shows that, among people with lupus, those who visited the emergency department were about twice as likely to use prescription opioids. Pain and impaired physical functioning were also significantly associated with opioid use. These latest findings come from data obtained from 462 people with lupus within the Michigan Lupus Epidemiology and Surveillance (MILES) cohort, which researchers compared against 192 individuals without lupus.
Lead author and mentor of a Lupus Foundation of America 2019 Gary S. Gilkeson Career Development Award recipient, Emily Somers, Ph.D, ScM, notes, “We know pain is very common in lupus, but prior to this study, data on patterns of prescription opioid use in lupus were lacking. Our study reveals very high levels of long-term prescription opioid use in the lupus population – often for longer than one year. For many patients, there are safer and more effective options for managing pain. We hope our findings will stimulate conversations between lupus patients and their providers about non-opioid strategies for addressing pain, including consideration of non-pharmacologic approaches such as self-management education programs for chronic disease, which can be effective as part of comprehensive pain management.”
Lupus can be an incredibly painful disease, from musculoskeletal pain (affecting bone, muscles, joints, and nerves) to centralized pain (related to fibromyalgia and the central nervous system). However, the authors note that opioids are generally not recommended for long-term pain management due to their lack of effectiveness, safety issues ranging from adverse medical effects to overdose, and risk for addiction.
What makes the findings even more striking: long-term opioid use may compound a multitude of health risks for someone with lupus. Long-term opioid use is associated with an increased risk of heart attack, immune system suppression, and osteoporosis, all of which are baseline health risks for a person with lupus. Early data also suggest that opioids are associated with increased risk of death in lupus.
While the findings are startling and significant, the study was characterized by some limitations, including the use of self-reported (and potentially under-reported) data around opioid use, reliance on figures from 2014-2015, and underrepresentation of some demographic groups. More research is needed, particularly to better understand pain management for people with complex chronic conditions like lupus and identify interventions to address opioid use. Learn about strategies for managing pain.