Opioid Analgesic Use and Risk for Invasive Pneumococcal Diseases
Authors: Andrew D. Wiese, Marie R. Griffin, William Schaffner, C. Michael Stein, Carlos G. Grijalva
Journal: Annals of Internal Medicine (2018)

Letters4 September 2018Opioid Analgesic Use and Risk for Invasive Pneumococcal DiseasesAndrew D. Wiese, PhD, Marie R. Griffin, MD, MPH, William Schaffner, MD, C. Michael Stein, MB, ChB, and Carlos G. Grijalva, MD, MPHAndrew D. Wiese, PhDVanderbilt University Medical Center, Nashville, Tennessee (A.D.W., M.R.G., W.S., C.M.S., C.G.G.)Search for more papers by this author, Marie R. Griffin, MD, MPHVanderbilt University Medical Center, Nashville, Tennessee (A.D.W., M.R.G., W.S., C.M.S., C.G.G.)Search for more papers by this author, William Schaffner, MDVanderbilt University Medical Center, Nashville, Tennessee (A.D.W., M.R.G., W.S., C.M.S., C.G.G.)Search for more papers by this author, C. Michael Stein, MB, ChBVanderbilt University Medical Center, Nashville, Tennessee (A.D.W., M.R.G., W.S., C.M.S., C.G.G.)Search for more papers by this author, and Carlos G. Grijalva, MD, MPHVanderbilt University Medical Center, Nashville, Tennessee (A.D.W., M.R.G., W.S., C.M.S., C.G.G.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L18-0295 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:The possibility of confounding by indication is a concern when conducting pharmacoepidemiologic studies, as discussed in our article. Although evidence from animal studies suggests that acute pain is associated with immune modulation, whether this relationship also exists among humans is not well understood (1, 2). In some studies, acute pain was linked to immunosuppression in patients who had surgery; however, whether pain or another factor related to surgery (for example, surgical trauma, hyperglycemia, or hypothermia) was the primary driver of immunosuppression remains to be determined (2, 3). Furthermore, whether pain is associated with a clinically important increased risk ...References1. Page G. The Immune-Suppressive Effects of Pain. Austin: Landes Bioscience; 2000. Google Scholar2. Kurosawa S, Kato M. Anesthetics, immune cells, and immune responses. J Anesth. 2008;22:263-77. [PMID: 18685933] doi:10.1007/s00540-008-0626-2 CrossrefMedlineGoogle Scholar3. Homburger JA, Meiler SE. Anesthesia drugs, immunity, and long-term outcome. Curr Opin Anaesthesiol. 2006;19:423-8. [PMID: 16829725] CrossrefMedlineGoogle Scholar4. Dublin S, Von Korff M. Prescription opioids and infection risk: research and caution needed. Ann Intern Med. 2018;168:444-5. [PMID: 29435579]. doi:10.7326/M18-0001 LinkGoogle Scholar5. Dublin S, Walker RL, Jackson ML, Nelson JC, Weiss NS, Von Korff M, et al. Use of opioids or benzodiazepines and risk of pneumonia in older adults: a population-based case-control study. J Am Geriatr Soc. 2011;59:1899-907. [PMID: 22091503] doi:10.1111/j.1532-5415.2011.03586.x CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Vanderbilt University Medical Center, Nashville, Tennessee (A.D.W., M.R.G., W.S., C.M.S., C.G.G.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-1907. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoOpioid Analgesic Use and Risk for Invasive Pneumococcal Diseases Andrew D. Wiese , Marie R. Griffin , William Schaffner , C. Michael Stein , Robert A. Greevy , Edward F. Mitchel Jr. , and Carlos G. Grijalva Opioid Analgesic Use and Risk for Invasive Pneumococcal Diseases Toshihiko Takada and Yuki Kataoka Metrics Cited byOpioids for chronic pain management in patients with dialysis-dependent kidney failureOpioid use disorder and endocarditisFederal and State Action Needed to End the Infectious Complications of Illicit Drug Use in the United States: IDSA and HIVMA’s Advocacy AgendaOpioids and Cancer MortalityLong-acting Opioid Use and the Risk of Serious Infections: A Retrospective Cohort Study 4 September 2018Volume 169, Issue 5Page: 355KeywordsAnalgesicsDisclosureHospitalizationsHypothermiaMedical risk factorsOpioidsPneumoniaPopulation statisticsRisk managementTrauma surgery ePublished: 4 September 2018 Issue Published: 4 September 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...