A new study in the Canadian Medical Association Journal shows chronic users of opioids have a life expectancy decades lower than the average.
The study also found those with Opioid Use Disorder (OUD) could benefit from better access to palliative care.
The article, Association between opioid use disorder and palliative care: a cohort study using linked health administrative data in Ontario, Canada, said health-care providers who support people with opioid addictions should receive training in palliative care and addiction medicine to support people with OUD. It was written by physicians and research scientists in Toronto and Ottawa.
"We identified important differences in palliative care provided at the end of life between people with and without OUD. People with OUD were less likely to receive palliative care," the authors wrote.
"Opioid use disorder can be a chronic, life-limiting illness, and people with OUD are less likely to receive palliative care in communities during the 90 days before death. Health-care providers should receive training in palliative care and addiction medicine to support people with OUD," the study said.
Future work is needed to evaluate the impact of palliative care on opioid prescribing, health-care use, and place of death for people with OUD, and to explore the end-of-life experiences of people with OUD and their caregivers, said the authors.
The researchers said their study gathered data from health databases in Ontario to identify people who died between July 1, 2015, and Dec. 31, 2021.
The study said that of the 679,840 people who died, 11 200 (1.6 per cent) had OUD. Also, compared with people without OUD, those with OUD died at a younger age, said the study.
"Among all decedents, the mean age at death was 77 years,” said the study. "People with OUD died at a much younger age than those without OUD (49.8 years)."
The study also commented on the social backgrounds of those people with opioid addictions.
"Those with OUD died at a younger age and were more likely to live in neighbourhoods with high marginalization indices (low incomes, poor housing, highest material deprivation)," said the study.
The authors also wrote that as the population ages more people with OUD will need access to palliative care at the end of their lives. The study also said that "people with OUD who survive nonfatal opioid poisoning can have severe complications such as hypoxic brain injury, as well as serious infections from injecting opioids".
The authors also commented on other illnesses and conditions likely to affect those with serious opioid addictions.
"People with OUD had higher prevalence of several clinical diagnoses, particularly Hepatitis C , mood disorders. and other mental health disorders. People with OUD were also more likely to have a history of harms associated with alcohol and stimulants."
A full text version of the study can be found online here.
