US Pharm. 2019;44(3):33-35.

Taking prescribed opioids raises the risk of pneumonia in individuals with and without HIV, a new Yale University–led study finds. The analysis, published in JAMA Internal Medicine, reinforces the concern that prescription opioid painkillers have a negative impact on the immune system. The results also underscore the need for awareness among opioid prescribers, who can take steps to minimize the risk of pneumonia through vaccination and promoting smoking cessation, the researchers said. To their knowledge, this is the first study to examine the impact of prescribed opioids on pneumonia risk in patients with HIV.

Commonly prescribed to individuals for pain, especially patients with HIV, there is evidence that some opioids—including codeine, fentanyl, and morphine—suppress the immune system and limit the body’s ability to fight bacterial infections, such as pneumonia. To explore the link between prescribed opioids and pneumonia, the research team analyzed data from patients enrolled in the Veterans Aging Cohort Study, a national study of individuals who receive care through the Veterans Health Administration (VA).

The study scientists utilized data from individuals who were treated at a VA between 2000 and 2012, including patients living with and without HIV. The research team matched patients hospitalized for pneumonia with similar patients who did not have pneumonia.

The researchers discovered that patients prescribed medium or high doses of opioid painkillers were at greater risk for pneumonia than those who were not prescribed the pain medications. The risk, they found, was increased if the opioid contained immunosuppressive properties. Individuals with HIV tended to be more likely to develop pneumonia even, at low doses of opioids, and especially with immunosuppressive opioids.