Front of Line Vaccine Privileges for Pain Patients on LTOT?

[drusso]

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Should patients on opioid and "immune suppressed" go to the front of the line for vaccination?

Op-Ed: COVID and Chronic Pain

Pandemic highlights the need for tailored approaches

www.medpagetoday.com

"Chronic pain has been linked to a lack of mobility and daily activity, socioeconomic status, access to healthcare, and opioid dependence. These correlations have recently been intensified as the pandemic has exacerbated income inequity, lack of access to affordable healthcare, and physical and emotional isolation making the treatment of chronic pain even more challenging."

 

[SommeRiver]

Universe is already trying to kill them - No.

 

[emd123]

This decision should be up to them and their PCP. I'm going to stay out of it. "Call your PCP to find out today!"

 

[geauxg8rs]

Back of the line. People who are employed should go before those who are “disabled.” They can just stay home

 

[Ducttape]

Chronic opioid therapy is much more a than other chronic medical conditions such as elderly or CAD or hypertension.

(yes someone will bring up diabetes, etc but the integral difference is that one can stop opioids, and weight loss does not result in end of diabetes, and we all do have to eat...)

these patients may qualify based on other comorbidities of course, but being on opioids should not be one of them.

 

[drusso]

Chronic opioid therapy is much more a than other chronic medical conditions such as elderly or CAD or hypertension.

(yes someone will bring up diabetes, etc but the integral difference is that one can stop opioids, and weight loss does not result in end of diabetes, and we all do have to eat...)

these patients may qualify based on other comorbidities of course, but being on opioids should not be one of them.

Review

Am J Ther

Sep-Oct 2004;11(5):354-65.
doi: 10.1097/01.mjt.0000132250.95650.85.

Opioid therapy and immunosuppression: a review​

Ricardo Vallejo 1, Oscar de Leon-Casasola, Ramsun Benyamin
Affiliations expand

• PMID: 15356431
• DOI: 10.1097/01.mjt.0000132250.95650.85

Abstract​

The idea that opioids modulate the immune system is not new. By the late 19th century, Cantacuzene, used morphine to suppress cellular immunity and lower the resistance of guinea pigs to bacterial infection. While exogenous opioids mediate immunosuppression, endogenous opiates exert opposite actions. Acute and chronic opioid administration is known to have inhibitory effects on humoral and cellular immune responses including antibody production, natural killer cell activity, cytokine expression, and phagocytic activity. Opiates behave like cytokines, modulating the immune response by interaction with their receptors in the central nervous system and in the periphery. Potential mechanisms by which central opiates modulate peripheral immune functions may involve both the hypothalamic-pituitary-adrenal axis and the autonomic nervous system. The presence of opioid receptors outside the central nervous system is increasingly recognized. Those receptors have been identified not only in peripheral nerves but also in immune inflammatory cells. The immunosuppression mediated by opiates may explain the increased incidence of infection in heroin addicts. Opiates may also promote immunodeficiency virus infection by decreasing the secretion of alpha and beta chemokines (important inhibitory cytokines for the expression of HIV) and at the same time increasing the expression of chemoreceptors CCR5 and CCR3, coreceptors for the virus. The fact that peripheral immunosupression is mediated at least in part by opioid receptors located in the central nervous system and that intrathecally administered opioids do not exert the same immunosuppressive effects may have important clinical implications for those patients receiving long-term opioid therapy for malignant and nonmalignant pain.

 

[Baron Samedi]

Most of them don't believe in vaccines

 

[NJPAIN]

Percocet will protect them from everything.