{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:48:14Z","timestamp":1792601294706,"version":"4.5.0"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2006,6,15]],"date-time":"2006-06-15T00:00:00Z","timestamp":1150329600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Internal Medicine"],"published-print":{"date-parts":[[2006,7]]},"abstract":"<jats:title>Abstract.<\/jats:title><jats:p><jats:bold>Objectives.\u2002<\/jats:bold> To study the effect of morphine and opiates on fracture risk.<\/jats:p><jats:p><jats:bold>Design.\u2002<\/jats:bold> Case\u2013control study.<\/jats:p><jats:p><jats:bold>Setting.\u2002<\/jats:bold> Nationwide register\u2010based study.<\/jats:p><jats:p><jats:bold>Subjects.\u2002<\/jats:bold> Cases were all subjects with any fracture sustained during the year 2000 (<jats:italic>n<\/jats:italic>\u2003=\u2003124\u2003655). For each case, three controls (<jats:italic>n<\/jats:italic>\u2003=\u2003373\u2003962) matched on age and gender were randomly drawn from the background population. The primary exposure variables were use of morphine and opiates. Morphine and other opiates had been used by 10\u2003015 (8.0%) of the case subjects and 12\u2003108 (3.2%) of the controls. Adjustments were made for several confounders including prior fracture, and use of weak analgesics [nonsteroidal anti\u2010inflammatory drugs, acetylsalicylic acid (ASA) and acetaminophene]. The effect of dose was examined by stratifying for cumulated dose (defined daily dose).<\/jats:p><jats:p><jats:bold>Main outcome measure.\u2002<\/jats:bold> Fracture.<\/jats:p><jats:p><jats:bold>Results.\u2002<\/jats:bold> Morphine (1.47, 95% CI 1.37\u20131.58), fentanyl (2.23, 95% CI 1.89\u20132.64), methadone (1.39, 95% CI 1.05\u20131.83), oxycodone (1.36, 95% CI 1.08\u20131.69), nicomorphine (1.57, 95% CI 1.38\u20131.78), ketobemidone (1.07, 95% CI 1.02\u20131.13), tramadol (1.54, 95% CI 1.49\u20131.58) and codeine (1.16, 95% CI 1.12\u20131.20) were all associated with an increase in overall fracture risk. No increase was present for buprenorphine (0.86, 95% CI 0.79\u20130.95), pethidine (0.98, 95% CI 0.89\u20131.08), dextropropoxiphene (1.02, 95% CI 0.90\u20131.16), and combinations of ASA and codeine (0.94, 95% CI 0.88\u20131.01).<\/jats:p><jats:p><jats:bold>Conclusions.\u2002<\/jats:bold> An increased fracture risk is seen in users of morphine and opiates. The reason for this may be related to the risk of falls due to central nervous system effects such as dizziness.<\/jats:p>","DOI":"10.1111\/j.1365-2796.2006.01667.x","type":"journal-article","created":{"date-parts":[[2006,6,15]],"date-time":"2006-06-15T12:02:47Z","timestamp":1150372967000},"page":"76-87","source":"Crossref","is-referenced-by-count":200,"title":["Fracture risk associated with the use of morphine and opiates"],"prefix":"10.1111","volume":"260","author":[{"given":"P.","family":"VESTERGAARD","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"REJNMARK","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"MOSEKILDE","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,6,15]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.8.949"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/jech.49.6.597"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002239900679"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1532-5415.2002.50453.x"},{"key":"e_1_2_7_6_2","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1197\/j.aem.2004.06.011","article-title":"Comparison of valdecoxib and an oxycodone\u2010acetaminophen combination for acute musculoskeletal pain in the emergency department: a randomized controlled trial","volume":"11","author":"Lovell SJ","year":"2004","journal-title":"Acad Emerg Med"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.287.5462.2398"},{"key":"e_1_2_7_8_2","first-page":"263","article-title":"The Danish National Hospital Register","volume":"46","author":"Andersen TF","year":"1999","journal-title":"Dan Med Bull"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwf007"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/8756-3282(88)90009-9"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a116396"},{"key":"e_1_2_7_12_2","first-page":"55","volume-title":"Drug Utilization Studies: Methods and Uses","author":"Capella D","year":"1993"},{"key":"e_1_2_7_13_2","doi-asserted-by":"crossref","first-page":"203","DOI":"10.3233\/JRS-1997-10309","article-title":"The pharmaco\u2010epidemiologic prescription database of North Jutland","volume":"10","author":"Nielsen GL","year":"1997","journal-title":"Int J Risk Saf Med"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(02)00585-1"},{"key":"e_1_2_7_16_2","first-page":"82","article-title":"The Danish Psychiatric Central Register","volume":"44","author":"Munk\u2010J\u00f8rgensen P","year":"1997","journal-title":"Dan Med Bull"},{"key":"e_1_2_7_17_2","volume-title":"Theoretical Epidemiology: Principles of Occurrence Research in Medicine","author":"Miettinen OS.","year":"1985"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.321.7261.598"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02555094"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)07088-2"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1997.tb04632.x"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009760"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.1997.12.1.24"}],"container-title":["Journal of Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1365-2796.2006.01667.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1365-2796.2006.01667.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T16:39:59Z","timestamp":1697128799000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-2796.2006.01667.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,6,15]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2006,7]]}},"alternative-id":["10.1111\/j.1365-2796.2006.01667.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1365-2796.2006.01667.x","archive":["Portico"],"relation":{},"ISSN":["0954-6820","1365-2796"],"issn-type":[{"value":"0954-6820","type":"print"},{"value":"1365-2796","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,6,15]]}}}