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Reporting at EULAR, researchers found that opioid use by patients with rheumatic and musculoskeletal pain was on the rise in Europe.

Whether it be fentanyl, tramadol or tilidine, new European figures show that increasingly more people are taking opioids for pain connected with rheumatic and musculoskeletal diseases.

The European League Against Rheumatism (EULAR) reported the findings at its recent virtual conference and warned of a growing risk of opioid abuse in Europe, calling for measures to use these analgesics more safely.

NDORMS DPhil Junqing Xie was lead author of a study that analysed the use opioids in patients with osteoarthritis in Catalonia, Spain from 2007 – 2016. Reviewing the health data of approximately six million patients, his research showed the use of the medication increased from 15 to 25 percent during that time.

"Taking opioids, in particular strong opioids, has substantially increased in recent years in patients newly suffering from osteoarthritis," said Junqing. "Precautions must urgently be taken so that these medications are prescribed safely."

The Catalonia study identified certain groups that showed an increased risk for addiction or dependency. Women were 4% more often affected than men, the elderly were 10% more affected than younger populations, and those with a lower socioeconomic status were 6% more likely to be affected than more privileged groups. Residents of rural areas were 1% more likely to take opioids compared to urban residents.

A separate study in Iceland not only showed that the taking of opioids frequently continues even after the source of pain has gone, but that their consumption actually increases. "It is a matter of urgency", says EULAR President Professor Iain B. McInnes from Glasgow, Scotland, UK.

Opioids are strong analgesics effective for patients with chronic non-tumor associated pains, such as chronic osteoarthritis. However, after a prescribed dose of treatment they should stop being taken. Their strong side effects include effects to the central nervous system which are sometimes mood enhancing. "This accounts for their strong addiction potential: For most patients, the physical withdrawal is therefore the most difficult," said Professor Ulf Müller-Ladner, EULAR Past Chair of Standing Committee on Clinical Affairs and Medical Director of the Rheumatology and Clinical Immunology Department of the Kerckhoff Clinic in Bad Nauheim, Germany.

The risk of physical and psychological addiction development is, however, low when opioids are used as intended. "Therefore, we would like to raise awareness of a responsible approach both by the prescribers and also the patients", says Professor John Isaacs from the University of Newcastle, UK, who is currently the EULAR Scientific Committee Chair.

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