Opioid-Induced Adrenal Insufficiency

Diane Donegan; Irina Bancos

doi:10.1016/j.mayocp.2018.04.010

Opioid-Induced Adrenal Insufficiency

Mayo Clin Proc. 2018 Jul;93(7):937-944. doi: 10.1016/j.mayocp.2018.04.010.

Authors

Diane Donegan¹, Irina Bancos²

Affiliations

¹ Division of Endocrinology, Diabetes and Metabolism, Indiana University, Indianapolis, IN. Electronic address: diadoneg@iu.edu.
² Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN.

PMID: 29976376
DOI: 10.1016/j.mayocp.2018.04.010

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.

Publication types

Review

MeSH terms

Adrenal Insufficiency / chemically induced*
Adrenal Insufficiency / diagnosis*
Adrenal Insufficiency / therapy
Analgesics, Opioid / adverse effects*
Humans

Substances

Analgesics, Opioid