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Researchers Recommend Against Chronic Opioid Use for Fibromyalgia

  [ 21 votes ]   [ 3 Comments ] • February 8, 2013


Chronic Opioid Use in Fibromyalgia Syndrome: A Clinical Review.
– Source: Journal of Clinical Rheumatology, January 29, 2013

By Jacob T. Painter, PhD and Leslie J. Crofford, MD


Chronic opioid therapy in the treatment of chronic nonmalignant pain has increased drastically over the past decade. This is a worrisome trend in general, but specifically, given pathophysiologic characteristics seen in fibromyalgia (FM) syndrome patients, the use of this class of medication deserves special scrutiny.

  • We first describe the current understanding of the etiology and pathophysiology of FM, including the role of genetic and environmental factors in the development of this syndrome.

  • We then discuss the biologic effects of opioid use.

  • Next, we review the pharmaceutical treatment options for FM, including 3 Food and Drug Administration-approved medications, and the evolution of treatment guidelines since 2004.

  • We then highlight the various consequences associated with the mechanism of action of opioids and the specific concerns for FM patients.

Finally, summarizing the existing literature, we make the case that chronic opioid use is inappropriate in the treatment of FM because of the interaction of unique pathophysiologic characteristics of the patients and effects associated with chronic opioid use.

Source: Journal of Clinical Rheumatology, January 29, 2013.  By Jacob T. Painter, PhD and Leslie J. Crofford, MD. Division of Pharmaceutical Evaluation & Policy, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR; and Division of Rheumatology & Women's Health College of Medicine, Department of Internal Medicine, University of Kentucky, Lexington, KY.

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Article Comments Post a Comment

Provide solutions not more whining about opioid abuse
Posted by: ldylarke
Feb 9, 2013
For a great many of us, prescription medication is the ONLY thing our insurance covers. By all means, if there were affordable alternatives offered, I'm sure lots of Fibro patients would try them quite happily.

Sadly, the health care community and the "Powers That Be" seem to be MORE concerned with opioid abuse than finding reasonable non-opioid pain relief solutions for chronic pain patients.

It is disgustingly apparent that Fibro patients have to fight tooth and nail just to be taken seriously, let alone be treated FAIRLY by the health care community. Instead of taking away our RIGHT to have access to pain relief medication, why not focus on creating access to alternative, affordable treatments?

IF only our quality of life could be improved, we'd gladly return to work. Sadly, we are beggared due to loss of the jobs we can no longer do, refused access to pain relief medication and cannot afford any alternative medicine options.

No wonder "The Powers That Be" and a majority of doctors and health care industry workers think we are a burden on society and deserve their disdain. If our government and the health care system won't help us, who will? No one. We continue to suffer outrageous levels of pain because no one wants to take responsibility for anything at all.

Shannon @
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Opiates for FMS
Posted by: KerryK
Feb 9, 2013
I think it is unfortunate that there is a tide of opinion against opiate use for FM. For many, the usual other meds are inadequate and usually very expensive and often have their own very serious side effects like cardiac or bleeding risks. So, that only leaves opiates which for many are all that work adequately. So out of an over-abundance of concern over addiction and respiratory depression, some would rather leave us under treated than treat us as adults and allow us to make our own decisions about risks and benefits. Further, so what if one becomes addicted while receiving necessary pain relief?
Reply Reply

Opioid use in CF/ME/FM
Posted by: ziggyziggy
Feb 9, 2013
The medical community that opposes opioid use to control pain for these chronic pain conditions fail to see the entire picture. It's ok to give us antidepressants that have serious mental and physical side affects and must be weened off and cost a small fortune but drugs that we know help the symptoms, are inexpensive and provide a sense of temporary relief are doled out as if we are all addicts using an excuse to get high need to rethink their theory. One way or another all these drugs need to be managed by a professional. If those who suffer a pain condition go in knowing they will have toto through a withdrawal process what's the difference what drug they take. There are plenty of safeguards in place to reduce abusers and a trained anesthesiologist can quickly spot the chronic drug addict and the chronic pain sufferer. Denying a pain sufferers medicine that works leaves them few choices and
may lead them to the streets for relief. Stop making the real patients the bad guy and stop trying to shove medicines who's side affects can lead to suicide into people in the ginnypig manner they are doing now because that's where the big bucks are.
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