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We looked at the health and lifestyle of people who regularly used prescription opioids. We also wanted to find out if regular opioid use was linked to an increased risk of dying. UK Biobank participants had told us the medicines they were using as well as answering questions about their health and lifestyle. We included the data of the 466,486 UK Biobank participants who did not have a previous history of cancer. Of these people 5.5% were regularly using opioid medications. Use of opioids increased with age, and was more common in women - 6.3% of women used opioids compared to 4.6% of men. Rates of opioid use were also related to socio-economic factors. The highest rates were in people with low income, in those who had left school before the age of 16, and in those who lived in areas of high deprivation. Among people who did not work because of ill-health a third were taking opioids. We also found that people regularly taking opioids were generally in poor health. Most people who used opioids said they had chronic pain (87%) or insomnia (89%). This suggests that opioids might not be working for the condition (i.e. chronic pain) they are being used for. Finally we found that regular opioid use was associated with premature death. Those taking strong opioids (9.1%) or weak opioids (6.9%) were more likely to die during the follow-up period than non-users (3.3%). This was true even after taking into account differences in health, socio-economic and lifestyle factors between those taking opioids and those not. This increase in deaths was due to disease rather than to accidents or other outside causes. We concluded that regular use of opioids is common in Great Britain, particularly in groups of low socio-economic status. Most opioid users still report chronic pain and poor health generally. They are at increased risk of premature death although we did not conclude that opioid use caused those deaths. Opioid use is a major public health issue. There is a need for better ways of helping people who want to stop using them and to offer different methods of managing chronic pain.
Epidemiology of chronic pain
This project will investigate the epidemiology of chronic pain. It will determine:
* how common pain is at individual sites throughout the body as well as `widespread body pain`
*the factors associated with the reporting of pain including demographic (age, sex, socioeconomic status), lifestyle factors (smoking , alcohol, physical activity)
*other health related factors reported with pain (e.g. fatigue and mood disorders)
*whether persons who report pain also report markers of poor cardiovascular (heart) and respiratory (lung) health and whether their lifestyle puts them at an increased risk of cancer.
*the relationship between reporting of pain and history of falls and fractures.
The project meets Biobank's purpose by researching common and disabling symptoms in the population with a view to further understanding their aetiology. Such knowledge will help to inform the design of future trials to optimise management.
This application requires only data on the full cohort. project It requires linkage to cancer incidence and mortality data (as and when it becomes available), and requires baseline data on lifestyle and psychosocial factors, medical conditions, bone densitometry and blood pressure;