Caution, Increased Education About Opioid Use for People With Heart Disease Urged by Experts

A new American Heart Association Presidential Advisory outlined the ongoing opioid epidemic and the advancing science on opioid use, including its effects on heart and brain health through evidence-based research, according to a press release from the American Heart Association (AHA).

The advisory notes different strategies for addressing the issue, such as:

• Improving education and training for the public and health care professionals on how to safely manage pain and opioid overdose.
• Support treatment for opioid use disorder, including creating and developing partnerships with federal, state, local, and employer-based programs.

“Opioid abuse accelerated during the COVID-19 pandemic due to disruption of the illicit drug supply environment, more limited access to medications, and social isolation and depression related to pandemic safety measures,” said chair of the writing group, Sheryl L. Chow, PharmD, FAHA, in a press release. “Opioid overdose is now a leading cause of death for Americans 25 to 54 years of age, and opioid use disorder affects more than 2 million Americans.”

The AHA worked with a team of leading health authorities to develop the advisory, which highlights recommendations, algorithms, and guidance for health care professionals and researchers who specialize in heart and brain health. The volunteer writing group was able to use data and information for more than 90 evidence-based epidemiology studies, reviews, consensus statements, and guidelines already published, according to the AHA.

“Health care professionals who manage pain in the setting of cardiovascular disease and stroke should be encouraged to receive training in management of pain using non-opioid strategies and on screening for opioid use disorder,” Chow said in the press release. “Lay responders should also be encouraged to receive formal CPR training with specific instructions on naloxone administration because opioid overdose often occurs in public, and CPR is more likely to be given by bystanders.”

Other key points in the advisory include:

1. CPR guidelines and algorithms that are reviewed for both health care professionals and rescuers when a person has a suspected opioid overdose.
2. People with cardiovascular disease and muscle/joint pain, acetaminophen, aspirin, and non-acetylated salicylates being considered first for pain management as alternatives to opioids.
3. An expansion of free, syringe exchange programs being considered to reduce the risk of infective endocarditis, which can occur when needles are shared for intravenous drug use.

“This advisory includes both immediate and long-term strategies to help mitigate the devastating intersection of opioid abuse and cardiovascular disease,” said Ivor J. Benjamin, MD, FAHA, former president of the AHA in a press release. “Together with our partners throughout public health, policy and government infrastructures, we can help support health care professionals and people in our communities more effectively avoid the preventable deaths caused by opioid use disorder and opioid overdose.”

REFERENCE

Experts urge caution, increased education about opioid use for people with heart disease. American Heart Association. August 19, 2021. Accessed August 19, 2021. https://newsroom.heart.org/news/experts-urge-caution-increased-education-about-opioid-use-for-people-with-heart-disease