Patients suffering from gout are 36% more likely to develop chronic opioid use compared to those without the condition, as revealed by recent research. This study, conducted by Lindsay Helget, MD, and her team at Nebraska Medical Center, aimed to examine the risk of chronic opioid use in patients with gout and identify its determinants.
Gout, a form of arthritis characterized by severe joint pain, often leads to the prescription of opioids for pain management, even though opioids are not the recommended treatment. Surprisingly, the study found that over 28% of patients with acute gout received opioid prescriptions, with more than a quarter of them being treated with opioids for more than 14 days. Patients with diabetes, gout attacks affecting multiple joints, and a history of opioid use prior to hospital visits were more likely to be prescribed opioids.
The researchers emphasized that there are alternative medications available that can effectively treat acute gout, significantly reducing the need for opioids. Deepan Dalal, MD, MPH, from Brown University Warren Alpert School of Medicine, stressed the importance of reducing the burden of prescription opioids, given that many patients are being treated with opioids for extended periods.
The study analyzed data from the national Veteran’s Health Administration from 1999 to 2015. The researchers compared cohorts of gout patients and non-gout patients, matching them based on birth year, sex, and Veteran’s Health Administration enrollment year. They observed the participants from the index date until the first incidence of chronic opioid use, death, or 5 years after the index date. Individuals who had taken opioids in the year before the index date were excluded.
The findings showed that 6.9% of gout patients had chronic opioid use, compared to 3.8% of non-gout patients. Even after adjusting for various factors, including demographic characteristics and comorbidities, gout patients were still significantly more likely to develop chronic opioid use.
The researchers emphasized the need for better care in managing gout, particularly among underserved populations, such as Black/African American and rural communities. They also highlighted the potential of adequate urate control in reducing the risk of chronic opioid use in gout.
Overall, this study sheds light on the increased risk of chronic opioid use in patients with gout and emphasizes the importance of exploring non-opioid treatment options for managing gout flares.
Q: What is gout?
Gout is a form of inflammatory arthritis characterized by severe pain, redness, and swelling in the joints, often affecting the big toe.
Q: Why are opioids not recommended for treating gout?
Opioids are not the preferred treatment for gout because there are alternative medications available that can effectively manage acute gout pain without the risks associated with opioids.
Q: What are the potential determinants of chronic opioid use in gout patients?
According to the study, patients with gout who had diabetes, gout attacks affecting multiple joints, and a history of prior opioid use were more likely to receive opioid prescriptions.
Q: How can the risk of chronic opioid use be reduced in gout patients?
The researchers suggested that ensuring adequate urate control for gout patients could potentially reduce the risk of chronic opioid use. Additionally, promoting non-opioid pain management strategies for gout flares can play a significant role in reducing the burden of prescription opioids in this population.