The Links Between Opioids and Coronary Heart Disease

Roughly one in four patients with prescribed opioids misuse them, according to the National Institute on Drug Abuse (NIDA).  Further, the NIDA reports that opioid abuse leads to the death of more than 130 people in the United States each day.The misuse of prescription opioids, heroin, and synthetic opioids, like fentanyl, is considered a national health crisis, threatening social and economic welfare. The epidemic’s economic burden in the United States is estimated at $78.5 billion.In addition to the crisis’ impact on families, finances, and futures, there are growing concerns and scientific evidence that shows cardiovascular dangers are emerging from opioid misuse.

Potential cardiovascular factors that should be considered

Opioid use may aggravate the risk of cardiovascular disease as opioids increase the biochemical standards of disorders related to heart conditions, such as low-density lipoproteins and free triglycerides. High levels of lipoproteins and the metabolites of dietary fats in the body are associated with greater risks of atherosclerosis, stroke, and heart attacks.One advanced biomedical research study showed that patients who abused opioids and needed coronary artery bypass surgeries had low-density lipoprotein and triglyceride concentrations that were much higher than those who needed the surgeries and were not substance abusers.Due to the factors mentioned above, researchers concluded that there was a direct correlation between opioid abuse and worsening lipid profile, hypercholesterolemia, and coronary artery disease.

Opioid use increases a person’s chances of developing atrial fibrillation

A study in circulation showed that opioid use may increase the risk of atrial fibrillation (Afib), which is caused by chaotic, irregular electrical impulses in the atria and can lead to stroke. The study showed the opioid use increased a person’s chances of experiencing atrial fibrillation by 34%.

Opioid withdrawal may induce heart failure

Takotsubo cardiomyopathy (TC) is a temporary heart condition often brought on by stress in postmenopausal women. When TC occurs the heart’s main pumping chamber, the left ventricle, weakens, usually due to severe emotional or physical stress. It is also referred to as broken heart syndrome because it occurs most often following a loved one’s death, a natural disaster like a hurricane, or another serious accident.Researchers are also seeing a condition known as “broken heart syndrome” among those withdrawing from opioids. Some researchers believe patients who have issues with dependency may be predisposed to TC.In light of the increase of opioid use, researchers encourage doctors to be aware of the possibility of this occurring in these patients. Therefore, doctors should have high levels of suspicion for opioid-withdrawal induced cardiomyopathy when there is a presence of cardiac symptomatology.

What doctors can do to prevent misuse

Doctors can help prevent a patient’s opioid abuse from escalating by knowing how to recognize a problem. Doctors should question patients about all drugs they are taking and help them recognize if they have problems. If one exists, the person should be referred for appropriate treatment. Evidence-based screening tools are available to help doctors detect the usage of non-medical usage of prescription drugs. These screening tools can be integrated into regular medical checkups.Doctors should be mindful if a patient rapidly increases the amount of prescription medicine needed or begins making for more frequent requests for refills. Additionally, doctors should be on the lookout for patients who may be “doctor shopping” so they can obtain multiple prescriptions for drugs.Other important tools that help prevent and identify prescription medication misuse or abuse include:

• Prescription drug monitoring programs (PDMPs)
• State-operated electronic databases, which are used to track the prescribing and dispensing of controlled prescriptions

More information is available for healthcare providers

Serious medical complications and even death may occur when substance abuse is complicated by additional medical problems, such as cardiovascular disease. Knowing the signs of opioid misuse can help get people the help they need and help curb the epidemic.Learn more about how to integrate prescription drug monitoring into patients’ regular medical visits.