The negative effects opioids can have on multiple body systems

The side effects of opioids often outweigh the benefits of their pain-relieving properties. To illustrate these effects, we share the story of Anne, a 45 year-old woman who injured her back while moving a heavy box at work. Anne was diagnosed with a lumbar radiculopathy due to a herniated intervertebral disc. Over the course of her claim, her medical providers prescribed multiple opioids, including short-acting and long-acting pills, as well as transdermal (applied to the skin) opioid medications.

While she experienced minimal to no lasting pain relief, she developed profound side effects and was placed at a heightened level of risk for serious (and potentially fatal) complications as her opioid medications either directly affected or placed many of her body systems in danger.

Nervous ​system

The central nervous system, made up of the brain and spinal cord, is particularly vulnerable to the effects of opioids. For instance, opioids can increase the likelihood of or further worsen preexisting depression. Depression is often accompanied by sleep disturbances, either insomnia or excessive daytime sleepiness. This was the case for Anne as her underlying depression was substantially worsened as a result of the opioids and she struggled with staying awake during the day.

Skeletal ​system

Opioids place people at a higher risk of bone thinning or osteoporosis, which is an impairment of the bone regulation and regrowth process. Anne’s cognition was significantly impaired by her medications, causing her to fall multiple times at home and once while in her doctor’s office. Although she did not sustain any fractures, she was at a higher risk for bone injury as a result of the opioids being taken.

 Muscular ​system

Anne had developed depression and excessive fatigue from her pain medications, specifically the opioids, to the point that she was no longer active, causing her muscles to weaken and her overall endurance to decline. Opioids can also affect the body’s hormones and further negatively affect muscle mass and strength. 

Respiratory ​system

Due to the number of opioids Anne was taking and their potential interactions with her other medications, including multiple muscle relaxants, she was placed at a high risk of overdose and respiratory depression. Opioids decrease the brain’s ability to sense high levels of carbon dioxide in the blood and diminish the amount of air breathed in by the lungs. This is how people die from opioid overdose.

Cardiovascular ​system

Anne had been experiencing chest pains during her recovery. While she was never diagnosed with heart disease, some individual opioids have been associated with a small increased risk of myocardial infarction or heart attack. 

Urinary ​system

The ability to urinate can be affected by opioids as it was with Anne. She developed a condition called urinary retention or failure to completely empty her bladder. Opioids can decrease the sensation of a full bladder and increase the resistance to urine flow. Both situations, when left untreated, can contribute to urinary tract infections and kidney damage.

Digestive ​system

Nausea, vomiting, and constipation are common side effects of opioids, which can be caused by slower digestion. Anne experienced extreme difficulties with constipation while taking opioids.

Integumentary ​system

The integumentary system, predominantly comprised of the skin, can be affected by opioids and medications applied to the skin. In Anne’s case, one of the opioid medications she used was a patch that caused an allergic reaction and resultant rash.

Understanding and recognizing the potential side effects of opioid medications aids in the recovery of injured workers. Teaming with a pharmacy benefit manager (PBM) could have helped proactively identify the medication complications Anne was experiencing, reduced the impact of each condition she had, and further reduced the risk of additional side effects. A PBM would not only have identified the aforementioned clinical concerns, but also worked with the professional administering the claim to take action. This undoubtedly would have yielded better outcomes – not just financially because of cost savings from the elimination of excessive treatment, but clinically in response to Anne receiving safer, more efficacious therapy.

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Anne Cover Image