The Effect of Opiates on Bone Formation and Bone Healing

Coluzzi, Flaminia; Scerpa, Maria Sole; Centanni, Marco

doi:10.1007/s11914-020-00585-4

Cited by 30 publications

(18 citation statements)

References 48 publications

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“…Other than opioid-induced hypogonadism, the direct inhibitory action of the opioid on bone is another potential mechanism of bone pathology in opioid dependence population. This mechanism is supported by the presence of opioid receptors (mu, delta, and kappa) and opioid growth factor receptor on osteoblast [29,30]. Evidence of enhanced osteocalcin synthesis, osteoblast activation, and increase in bone mineralization following administration of naltrexone, an opioid antagonist, further supported the role of opioid in bone formation [29,30].…”

Section: Ivyspringmentioning

confidence: 90%

Factors Associated with Low Bone Density in Opioid Substitution Therapy Patients: A Systematic Review

2021

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Background: Long-term opioid therapy is a risk factor for low bone mineral density (BMD). However, other factors may also contribute to low BMD. Several studies have examined the variables that might contribute to low BMD in patients receiving opioid replacement therapy (OST). However, to our knowledge, there was no systemic review conducted to address this particular issue. Thus, we reviewed the articles on the factors associated with low BMD in the population of opioid use disorder receiving substitution therapy. Methods: The articles that examined correlates or risk factors of low BMD in OST population were retrieved from OVID, SCOPUS, and PUBMED from inception until July 2020 by two independent investigators. Results: A total of 429 articles from three databases were retrieved initially. After screening based on eligibility criteria, five articles were included in the final analysis. The risk factors or correlates found to be significantly associated with low BMD in the OST population include male gender, low body mass index, low testosterone level, methadone or heroin use, and longer duration of heavy alcohol use. The review limitations include small sample sizes and inconsistent definition of variables. Conclusion: OST patients should be screened for BMD and its associated factors. Guidelines and training of practitioners involving in the OST service should be provided to increase the detection of low BMD in the OST population.

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Section: Ivyspringmentioning

confidence: 90%

Factors Associated with Low Bone Density in Opioid Substitution Therapy Patients: A Systematic Review

2021

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“…Data regarding the impact of opioids on bone metabolism have been reported, albeit scarcely, in the literature. In vitro and in vivo investigations have reported that opioids can reduce osteoblastic and increased osteoclastic activity (Coluzzi et al., 2020). Specifically, it has been shown that the administration of fentanyl results in a reduction in bone volume, trabecular number, and density in a spinal fusion rabbit model (Jain et al., 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, it has been shown that the administration of fentanyl results in a reduction in bone volume, trabecular number, and density in a spinal fusion rabbit model (Jain et al., 2018). Although cohort studies assessing the impact of opioid use on bone fracture tend to primarily address the risk of falls due to CNS effects of such medications (Coluzzi et al., 2020), an epidemiological study by Zura et al reported that patients using opioids were at a slightly greater risk for fracture nonunion (OR: 1.43), especially when concomitantly consuming NSAIDs (OR: 1.84) (Zura et al., 2016). However, not all opioids are potentially detrimental to normal bone formation.…”

Section: Discussionmentioning

confidence: 99%

Surgery start time and early implant failure: A case–control study

Tattan

Puranam

Comnick

et al. 2021

Clinical Oral Implants Res

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Objective To evaluate the influence of surgery start time (SST) and other patient‐ and therapy‐related variables on the risk for early implant failure (EIF) in an academic setting. Material and Methods Data were extracted from the electronic health records of 61 patients who had at least one EIF and 140 age‐ and gender‐matched, randomly selected, non‐EIF controls. Bivariate and multivariable analyses were performed to identify relevant associations between EIF and different variables, such as SST. Results Incidence of EIF was not significantly associated with SST (HR: 1.9 for afternoon implant placement, 95% CI: 0.9–3.9; p = .105). Other factors that were associated with a significantly increased risk for EIF in a multivariable model were pre‐placement ridge augmentation (HR: 7.5, 95% CI: 2.2–25.1; p = .001), intra‐operative complications (HR: 5.9, 95% CI: 2.2–16.3; p < .001), simultaneous soft tissue grafting (HR: 5.03, 95% CI: 1.3–19.5; p = .020), simultaneous bone grafting (HR: 3.7, 95% CI: 1.6–8.8; p = .002), and placement with sedation (HR: 3.4, 95% CI: 1.5–7.5; p = .002). Conclusions While SST was not associated with the occurrence of EIF in our cohort, other variables, such as ridge augmentation prior to implant placement, simultaneous bone or soft tissue grafting, intra‐operative complications, implant placement with sedation, and number of implants in the oral cavity, were associated with an increased risk for this adverse event.

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“…Although there is, to our knowledge, no clinical data available on the effects of opioids on regeneration per se, several reports have shown that these peptides are associated with impaired fracture healing and nonunion risk in human [ 103 , 104 ] as well as impaired wound healing [ 105 ]. Nevertheless, two studies report beneficial or neutral effects of opioids on painful skin lesions [ 106 , 107 ].…”

Section: What Is Known In Human-being?mentioning

confidence: 99%

Tissue Regeneration: The Dark Side of Opioids

Berthézène

Rabiller

Jourdan

et al. 2021

IJMS

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Opioids are regarded as among the most effective analgesic drugs and their use for the management of pain is considered standard of care. Despite their systematic administration in the peri-operative period, their impact on tissue repair has been studied mainly in the context of scar healing and is only beginning to be documented in the context of true tissue regeneration. Indeed, in mammals, growing evidence shows that opioids direct tissue repair towards scar healing, with a loss of tissue function, instead of the regenerative process that allows for recovery of both the morphology and function of tissue. Here, we review recent studies that highlight how opioids may prevent a regenerative process by silencing nociceptive nerve activity and a powerful anti-inflammatory effect. These data open up new perspectives for inducing tissue regeneration and argue for opioid-restricted strategies for managing pain associated with tissue injury.

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The Effect of Opiates on Bone Formation and Bone Healing

Cited by 30 publications

References 48 publications

Factors Associated with Low Bone Density in Opioid Substitution Therapy Patients: A Systematic Review

Factors Associated with Low Bone Density in Opioid Substitution Therapy Patients: A Systematic Review

Surgery start time and early implant failure: A case–control study

Tissue Regeneration: The Dark Side of Opioids

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