Opioid-Induced Adrenal Insufficiency.

Diane Donegan, Irina Bancos

Journal: Mayo Clinic proceedings 2019;93(7):937-944

PMID: 29976376

Full Text on Elsevier Science View on PubMed

Abstract

One in 10 Americans experience chronic pain. Although opioids do play a role in the management of pain, long-term opioid use may lead to adverse effects. Endocrine-related adverse effects have been described but remain poorly recognized. Opioid-induced adrenal insufficiency occurs because of suppression of hypothalamic-pituitary-adrenal communication and may be challenging to diagnose but has been reported in 9% to 29% of patients receiving long-term opiate therapy. Little data exist to guide case detection and patient management. Treatment includes cessation of opiates (the inciting factor) if possible and glucocorticoid replacement.

Address: Division of Endocrinology, Diabetes and Metabolism, Indiana University, Indianapolis, IN. Electronic address: [email protected].; Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN.

DOI: 10.1016/j.mayocp.2018.04.010

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MeSH Terms: Adrenal Insufficiency, Analgesics, Opioid, Humans