Opioid use not only increases the risk of sudden death but is associated with developing serious and potentially life-threatening infections of the lung and brain, a US study has found.
The study, published in the Annals of Internal Medicine, found people who used opioids had a significant increased risk of developing pneumococcal diseases such as pneumonia and meningitis.
The association was strongest for those who used highly potent and long-acting opioids, said lead author Andrew Wiese, a post-doctoral research fellow at the Vanderbilt University School of Medicine.
"We also found that opioids previously prescribed as immunosuppressive in prior experimental studies conducted in animals, had the strongest association with invasive pneumococcal disease in humans," he said.
Invasive pneumococcal diseases are serious infections caused by the Streptococcus pneumoniae bacteria and have a mortality rate ranging from five to 20 per cent.
With data showing opioid use on the increase, the researchers said the findings were important for doctors.
"Providers should consider these results when making pain management decisions," Mr Wiese said.
For the study, researchers looked at the Tennessee Medicaid database to measure daily prescription opioid exposure.
The database included more than 1200 people aged five years and older who had a pneumococcal infection. The researchers compared these people to more than 24,000 people who were matched by age, diagnosis date and country of residence.
Opioid users were 1.62 times more likely to develop a pneumococcal infection, the study found.
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This suggests that taking the strong painkiller increases the risk of developing pneumonia or meningitis by about 60 per cent.
Dr Sascha Dublin, an Internal Medicine specialist at the University of Washington's School of Public Health, said until now "remarkably little" consideration has been given to the risk of infection caused by opioid use
The expert agrees this information is clinically important.
"Three decades of basic science and animal studies have found that some opioids have immunosuppressive properties, including reduction of natural killer cell cytotoxicity and impairment of neutrophil chemotaxis (the movement of an organism in response to a chemical stimulus) ," Dr Dublin wrote in an editorial.