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Can Opioids Suppress The Immune System?

Rheumatoid Arthritis (RA) is a progressive, painful crippling disease. It's unfortunately a common condition, and RA patients comprise a large segment of the chronic pain population. Fortunately, for the most part, the current standards of treatment for this condition do NOT include the use of opioids.




A recent study published in Arthritis & Rheumatology examined chronic opioid usage in almost 14,000 RA patients over a fourteen year period.  Surprisingly, when the patients in the study were using chronic opioids, they had a significant increase in rate of infection.  The study authors found a twofold risk of infection in opioid vs. non-opioid populations.

Why is this so?  In vitro studies have shown that certain opioids--morphine, methadone, and fentanyl--have immune suppressive properties. This can be attributed to inhibition of T-cell receptor signaling, reductions in natural killer cell activity, and depletion of lymphocytes, according to said studies.

The authors of the Arthritis & Rheumatology writings suggest that more study is needed to determine which opioids are most problematic.  But to me, it suggests that we ought to think twice before prescribing opioids for all patients...especially in the age of antibiotic resistance!

You can read more about this interesting phenomenon by clicking here.


Sources: PainMedicineNews; Wikimedia

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