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Association between opioid use disorder and fractures: a population-based study
Wen-Yu Hsu1,2,3, Cheng-Li Lin4,5, Chia-Hung Kao6,7,8
1Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.
Addiction (Abingdon, England)
|July 16, 2019
Summary
Patients with opioid use disorder (OUD) in Taiwan have a significantly higher risk of fractures. This study found OUD patients were over 4 times more likely to experience fractures compared to those without OUD.
Area of Science:
- Public Health
- Epidemiology
- Pharmacology
Background:
- Opioid use disorder (OUD) is a growing public health concern.
- The skeletal health implications of OUD require further investigation.
- Previous research has not fully elucidated the fracture risk associated with OUD.
Purpose of the Study:
- To determine if fractures and osteoporosis are more prevalent in patients with opioid use disorder (OUD) compared to those without OUD in Taiwan.
- To quantify the association between OUD and fracture incidence.
- To identify specific risk factors for fractures in patients with OUD.
Main Methods:
- A retrospective cohort study was conducted using Taiwan's National Health Insurance Research Database (NHIRD).
- Adult patients diagnosed with OUD (n=3695) and a control group without OUD (n=14,780) were identified from 1998 to 2011.
- Fracture incidence was the primary outcome, analyzed using Cox proportional hazard models, adjusting for covariates like age, sex, and comorbidities.
Main Results:
- Patients with OUD exhibited a significantly higher incidence rate of fractures (23.0 per 1000 person-years) compared to the control group (5.47 per 1000 person-years).
- The adjusted hazard ratio for fracture in patients with OUD was 3.74 (95% CI: 3.27-4.29), indicating a 4.13 times higher likelihood of fractures.
- Elevated fracture risk was particularly noted in male elderly patients with OUD, especially those with comorbidities such as diabetes mellitus, alcohol-related illness, or osteoporosis.
Conclusions:
- Taiwanese patients diagnosed with opioid use disorder (OUD) face a substantially increased risk of fractures.
- The findings underscore the importance of bone health monitoring and fracture prevention strategies in individuals with OUD.
- Public health initiatives should address the heightened fracture risk associated with OUD.
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