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PAIN IN 2019

Towards defining the safer use of opioids in rheumatology

Nature Reviews Rheumatology volume 16, pages 71–72 (2020)Cite this article

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Use of prescription opioids is prevalent in patients with rheumatic diseases. Studies in 2019 reported the trends and safety of opioids in patients with rheumatoid arthritis or osteoarthritis. Treating underlying disease processes must be the rheumatologists’ priority. Without better long-term safety and effectiveness data, opioid use should be generally limited.

Key advances

  • Chronic use of opioids in patients with rheumatoid arthritis in the USA doubled from 7.4% in 2002 to 16.9% in 2015 despite availability of a growing number of DMARDs2.

  • Implementation of a guideline-based opioid safety initiative led to a decrease in rates of opioid prescribing for osteoarthritis without changes in patient-reported pain intensity3.

  • Use of tramadol is associated with greater mortality compared with NSAIDs among older patients with osteoarthritis4.

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Fig. 1: Trends and safety in opioid use in 2019.

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Acknowledgements

S.C.K. is supported by NIH grants R01AR069557 and R01AR073314. D.H.S. is supported by NIH grants U01AR068043 and R01HL119718.

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Authors and Affiliations

  1. Division of Pharmacoepidemiology and Pharmacoeconomics and Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Seoyoung C. Kim & Daniel H. Solomon

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  1. Seoyoung C. Kim
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  2. Daniel H. Solomon
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Correspondence to Seoyoung C. Kim.

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Kim, S.C., Solomon, D.H. Towards defining the safer use of opioids in rheumatology. Nat Rev Rheumatol 16, 71–72 (2020). https://doi.org/10.1038/s41584-019-0360-1

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