Top Things to Know: Opioid Use and Its Relationship to Cardiovascular Disease and Brain Health
Published: August 19, 2021
- The misuse of opioids in the US continues to be an epidemic resulting in dependency and escalating drug overdoses leading to significant loss of life.
- The death rate from drug overdoses continues to rise in 2020 with the annual number of deaths increasing by 15.5% from December 2019 through June 2020 which have been further compounded during the COVID-19 pandemic.
- First alternatives to opioids in patients with musculoskeletal and cardiovascular disease include acetaminophen, aspirin, and non-acetylated salicylates.
- The routine use of morphine in the setting of acute coronary syndrome may adversely reduce the therapeutic efficacy of P2Y12 receptor antagonists.
- Parenteral antiplatelet agents can be considered for acute coronary syndrome when administered with morphine in the hospitalized setting.
- The AHA has guidelines for both healthcare professionals and lay responders on how to provide basic life support for a person with a suspected opioid overdose, with an emphasis placed on activating 9-1-1 quickly, initiating chest compressions immediately, administering naloxone and implementing an AED.
- Healthcare professionals who manage pain in the setting of CVD and stroke should be encouraged to receive training in non-opioid pain management strategies as well as opioid use disorder (OUD) screening.
- Expansion of syringe service programs should be considered to reduce risk of endocarditis.
- Harmonization of approaches to opioid management should occur among federal agencies and across states.
- There is an urgent need for research to identify the most effective approach for safe opioid use in cardiovascular and stroke patients, and to reduce opioid-associated complications.
Citation
Chow SL, Sasson C, Benjamin IJ, Califf RM, Compton WM, Oliva EM, Robson C, Sanchez EJ; on behalf of the American Heart Association. Opioid use and its relationship to cardiovascular disease and brain health: a presidential advisory from the American Heart Association [published online ahead of print August 19, 2021]. Circulation. doi: 10.1161/CIR.0000000000001007