Cardiovascular Risk Associated with Medical Use of Opioids and Cannabinoids: A Systematic Review

AbstractPurpose of ReviewThe long-term use of opioid and cannabinoid medications to control chronic pain and treat opioid use disorders now involves a large proportion of the population in the United States. Yet, the cardiovascular risks of opioids are not well understood. This systematic review summarizes the current literature to assess the potential cardiovascular disease risks associated with opioid and cannabinoid medications.Recent FindingsThe role of long-term methadone use in increasing QT interval among people receiving methadone treatment for substance use disorders is well established. Routine electrocardiogram screenings among patients receiving methadone treatment may be helpful in early identification and prevention of ventricular arrhythmias. There is limited, but credible evidence of increased risk for myocardial infarction among patients using opioid medications for chronic pain, and equivocal evidence that opioids may lead to hypotension in the short term. Further, there is no evidence indicating that opioid pain medications increase the risk of stroke or pulmonary embolism. However, the majority of the reviewed studies include limited internal and external validity due to poor confounding control, exposure misclassification, confounding by indication, small sample size, and non-generalizable special populations. We also did not find any human studies evaluating the cardiovascular effects of cannabinoids.SummaryWhile the effects of methadone on cardiac condu...
Source: Current Cardiovascular Risk Reports - Category: Cardiology Source Type: research