Category Archives: Risks

opiod risk

More Studies Show Opioids’ Risks Outweigh Benefits for Arthritis

Two new studies presented at the 2019 American College of Rheumatology Annual Meeting examine the role of opioid medications in treating rheumatic conditions. The first study found hospitalizations for opioid use disorder in people with osteoarthritis and other musculoskeletal disorders have surged over the past two decades. The second found that these drugs have only a small benefit for pain and function and do not significantly improve people’s quality of life. While these are just two of many studies on the topic, they highlight how complicated the treatment of chronic pain is.

The Centers for Disease Control and Prevention (CDC) has declared the opioid problem in this country an “epidemic.” Nearly 400,000 people died from opioid overdose between 1999 and 2017. Still, doctors continue to prescribe these drugs for patients who are in chronic pain.

Chronic musculoskeletal diseases, like arthritis, are among the top causes of chronic pain, so people with arthritis are at particularly high risk of receiving opioids and potentially developing an opioid use disorder (OUD), says lead study author Jasvinder Singh, MD, professor of medicine and epidemiology at the University of Alabama at Birmingham.

To understand the magnitude of the problem, Dr. Singh and his colleagues analyzed rates of OUD hospitalizations from 1998 to 2016 for five conditions: gout, osteoarthritis (OA), fibromyalgia, rheumatoid arthritis (RA) and low back pain.

Over that 19-year period, OUD-associated hospitalizations surged 24-fold for gout, nine-fold for OA and six-fold for RA. Eventually the rates of OUD leveled out for people with gout and low back pain, but continued to rise for those with OA or RA. “For some conditions, like gout and fibromyalgia and to some extent rheumatoid arthritis, we weren’t aware of how extensive the problem was,” Dr. Singh says.

Given the increasing awareness of the risks linked to opioid use, a drop in those numbers may occur as more recent data becomes available, Dr. Singh says. But until better solutions for chronic pain are available, opioids will likely remain an integral part of arthritis treatment. “We’re talking about diseases that outstrip cancer and heart disease in terms of numbers by several million in the United States. But the progress we’ve made in adequately treating pain in these conditions is somewhat limited,” he adds.

The other research presented at the conference included results from 23 studies on the efficacy of opioids in more than 11,000 people with knee and/or hip OA. The authors analyzed participants’ pain and function after two, four, eight and 12 weeks of opioid use. Although the drugs offered small improvements in pain and function after two to 12 weeks of treatment, they did not improve quality of life or depression.

“Additionally, we found that the magnitude of these effects [on pain and function] remains small and continues to decrease over time,” says lead author Raveendhara R. Bannaru, MD, PhD, director of the Center for Treatment Comparison and Integrative Analysis at Tufts Medical Center in Boston. “In light of dependency concerns and the discomfort that many patients feel while taking the drugs, it would appear that there is no optimal therapeutic window for the use of oral opioids in OA.”

Perhaps surprisingly, the authors found that strong opioids had consistently smaller effect on pain than weak opioids did. Dr. Bannaru says it’s possible that many participants who received strong opioids couldn’t reach a dose high enough to relieve their pain because they couldn’t tolerate the side effects. “Participants receiving strong opioids were twice as likely as participants receiving weak/intermediate opioids to discontinue the study due to adverse events,” he says.

Given the risk of dependency and side effects with opioids, the results of these studies should make people and their doctors more wary of these drugs. “I think that patients need to be fully informed with regard to benefits and risks,” Dr. Singh says. Having more information about opioid risks and their effects on quality of life from future studies should make it easier for patients and their doctors to choose the most appropriate pain reliever.

Author: Stephanie Watson for the Arthritis Foundation.

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smoking risks for arthritis

5 Reasons Smoking Makes Arthritis Worse

If the risks of lung disease, heart disease, cancer and bad breath weren’t good enough reasons for you to give up smoking, here’s something else you should know: Research shows that smoking is harmful to your bones, joints and connective tissue as well. No matter what form of arthritis you have, you’ll be doing your joints and yourself a favor by quitting. Here are five more reasons for people with arthritis to snuff the habit.

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arthritis medication infection risk

Infection Alert for People With Arthritis

If you have arthritis or take medications to treat it, a cough, fever or fatigue may be signs of infection. That’s because you may be more vulnerable to infections than the general population, says Dee Dee Wu, MD, a rheumatologist at the Hospital for Special Surgery in Paramus, New Jersey. Plus, infections can become serious, so treating them promptly is important.

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lupus rheumatoid arthritis blood clots

Arthritis Patients Face Increased Risk of Blood Clots

People with autoimmune disease such as lupus and rheumatoid arthritis (RA) are more likely to get dangerous blood clots during hospital stays. In fact, one 2014 Arthritis Research & Therapy meta-analysis of 25 studies found that people with inflammatory rheumatic diseases were three times more likely to experience venous thromboembolisms (VTEs, or blood clots in the veins) than the general population.

Lupus patients are four times more likely than people without an autoimmune disease to develop blood clots when hospitalized. And RA patients are one-and-a-half times more likely to develop blood clots during a hospital stay. According to a 2011 study from researchers in the United Kingdom, anyone with an immune-related disorder faces some sort of increased risk.

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Arthritis Facts and Myths

Debunking Common Myths About Arthritis

Arthritis is much more than a disease plaguing the elderly – it’s the No. 1 cause of disability in the U.S. and impacts more than 50 million Americans, including 300,000 children. It’s smart to learn about this common but painful disease. Do you think you know about arthritis? Test yourself with these arthritis myths and learn the facts.
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Bad Habits Arthritis

5 Bad Habits to Drop for Better Arthritis Management

In a perfect world, pain wouldn’t exist, our weight would be optimal and we’d enjoy daily exercise and have energy to spare. But the world is not perfect, and sometimes our bad habits get in the way of our best intentions to live a healthy life. You can make small changes toward adopting a healthier lifestyle and reducing your arthritis symptoms. Along with adopting the healthy habits in our previous blog post, make an effort to break these 5 unhealthy habits.

  1. Eating over-processed foods.

Sugar and white flour – and the overabundance of them in processed foods – can lead to weight gain, which is hard on sore joints. Replace them with fruits, nuts and whole grains. A good rule of thumb, says Rachel Brandeis, a registered dietitian in Atlanta, is to indulge in foods with fewer than 10 grams of sugar and more than 3 grams of fiber per serving. You’ll feel full on less and prevent weight gain. Continue reading 5 Bad Habits to Drop for Better Arthritis Management