People with an opioid dependency have a 56 per cent higher risk of developing dementia than the general population, according to a study by Oxford Population Health and the University of Oxford’s Department of Psychiatry.
Researchers analysed more than 220,000 health records from the US Million Veteran Program (MVP), a database of over a million US military personnel. Comparing the data to other large studies, they used genetic analysis to ‘disentangle’ opioid use from other potential causes of dementia. Almost 9,000 MVP participants had a diagnosis of opioid use disorder (OUD), and in the nine years of follow-up were found to be 56 per more likely to develop dementia than those without an OUD diagnosis.
Drawing conclusions from previous emerging evidence has been complicated by the challenges of distinguishing the effects of opioid addiction from other factors that could contribute to the development of dementia, such as problem alcohol use, psychiatric disorders or chronic pain, the researchers point out. Although the mechanisms linking opioids to dementia ‘remain unclear’, long-term use may contribute to hardening and narrowing of the arteries and hypotension which can reduce the flow of oxygen to the brain. Dementia may also have gone undiagnosed in people whose drug use may have ‘obscured the symptoms of cognitive decline’, they say.
‘While the short-term effects of opioids are well known, our findings show that opioid use disorder may also have important long-term consequences for brain health, including a higher risk of dementia,’ said lead author Dr Anya Topiwala. ‘Using large-scale data and genetic methods, we found evidence suggesting this link may be causal, pointing to the direct impact of opioid exposure rather than underlying genetic risk. This work underscores the need for medicine safety, preventive strategies, and further investigation into the neurological consequences of chronic opioid exposure.’
Meanwhile, a new report from ASH and the Mental Health and Smoking Partnership warns that 1.5m people in the UK with depression and anxiety are being left without support to quit smoking. Smoking rates among people with mental health conditions are significantly higher, but while there are ‘promising examples’ of local innovation these are being hampered by lack of a national strategy or national targets. An open letter to public health minister Sharon Hodgson to accompany the report is signed by more than 140 campaigners and health professionals.
Opioid use disorder and dementia risk: evidence from observational and genetic analyses in diverse ancestry cohorts is published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association and is available here
Falling through the cracks: Closing the gap in stop smoking support for people with common mental health conditions available hereÂ