Scientists have identified a list of opioid painkillers that may significantly increase the risk of death from overdose.

Experts stated that fentanyl is the most associated with fatal respiratory complications.

A study conducted by researchers from the University of Manchester showed that fentanyl is more strongly associated than others with respiratory depression, a condition in which breathing becomes dangerously slow or shallow, leading to a drop in oxygen levels in the body and accumulation of carbon dioxide in the blood, which can result in death if not medically intervened in time.

Opioid painkillers are widely used to relieve severe pain after surgeries or injuries, as well as in cancer patients, and include drugs such as morphine, codeine, and tramadol.

These drugs affect the nerve signals in the brain responsible for regulating breathing, which can lead to a severe lack of oxygen.

The study results come at a time when Britain is witnessing a significant increase in the use of these drugs, with the number of prescriptions for them doubling over the past 25 years amid growing concerns about addiction, according to the British newspaper Daily Mail.

This type of painkiller is currently prescribed to about 3.3 million adults for various conditions, including severe joint pain, surgery-related injuries, and cancer pain, and is also used in anesthesia during procedures.

The researchers, who published their findings in the medical journal BMC, analyzed electronic health records of 32,909 adults treated in hospitals in northwest England to determine which opioids are associated with the highest risk of life-threatening complications, especially in patients using them for non-cancer pain.

To achieve this, the team monitored medical indicators such as respiratory rate, blood oxygen levels, and the need for naloxone, a drug used to rescue people from opioid overdoses, and also tracked the timing of these drugs' administration to patients.

The results showed that patients who received fentanyl were three times more likely to develop breathing problems compared to those who used codeine, and their risk of respiratory depression was 85% higher compared to morphine patients.

The study also revealed that combining more than one opioid at the same time triples the risk of these fatal complications, while the risk of breathing problems increased by about 50% among those who used a combination of opioids compared to those who took morphine alone.

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High risk rates were also recorded among users of oxycodone and morphine compared to codeine.

Researchers suggest that the danger of fentanyl lies in its high potency and rapid entry into the brain, which leads to a sudden slowing of breathing.

The study also showed that people with chronic obstructive pulmonary disease (COPD) may be most vulnerable to the effects of these drugs, as fentanyl use in them was associated with a nearly fourfold increase in the risk of breathing problems compared to codeine, indicating that chronic lung patients need greater caution when prescribing these treatments.

Dr. Meghna Jani, Senior Clinical Lecturer at the University of Manchester and lead author of the study, said that opioids remain necessary for treating acute pain, but the study results confirm that the level of risk varies from drug to drug and from dose to dose.

The study added that higher doses increase the likelihood of complications, even in patients taking moderate doses between 31 and 60 mg morphine equivalent per day.

The risk also increases when these drugs are used with other medications such as gabapentin or pregabalin, which are commonly prescribed for nerve pain and epilepsy.

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