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Opioid Use in Fibromyalgia Associated with Poorer Outcomes

  [ 7 votes ]   [ 3 Comments ]
www.ProHealth.com • April 16, 2013


Note: You may read the full text of this article free HERE.

Opioid use in fibromyalgia is associated with negative health related measures in a prospective cohort study.
– Source: Pain Research and Treatment, Epub March 18, 2013

By Mary-Ann Fitzcharles, et al.

Abstract:

As pain is the cardinal symptom of fibromyalgia (FM), strategies directed towards pain relief are an integral component of treatment. Opioid medications comprise a category of pharmacologic treatments which have impact on pain in various conditions with best evidence for acute pain relief. Although opioid therapy other than tramadol has never been formally tested for treatment of pain in FM, these agents are commonly used by patients.

We have examined the effect of opioid treatments in patients diagnosed with FM and followed longitudinally in a multidisciplinary pain center over a period of 2 years.

In this first study reporting on health related measures and opioid use in FM, opioid users had poorer symptoms and functional and occupational status compared to nonusers.

Although opioid users may originally have had more severe symptoms at the onset of disease, we have no evidence that these agents improved status beyond standard care and may even have contributed to a less favourable outcome. Only a formal study of opioid use in FM will clarify this issue, but until then physicians must be vigilant regarding the multiple adverse consequences of opioid therapy.


Source: Pain Research and Treatment, Epub March 18, 2013. By Mary-Ann Fitzcharles, Neda Faregh, Peter A. Ste-Marie and Yoram Shir. Division of Rheumatology, McGill University, Montreal, QC, Canada H3G 1A4 ; Alan Edwards Pain Management Unit, Montreal General Hospital, McGill University Health Centre, 1650 Cedar Avenue, Montreal, QC, Canada H3G 1A4.

Editor's Comment:  In the full text of this study, the researchers noted, “Opioids are also perceived by patients to offer the best symptom relief according to an internet survey of persons with self-reported FM.”  Despite that perception, the FM patients who were taking strong opioids (all opioids other than tramadol and codeine) scored worse for symptom severity, functional impairment and occupational status over time.  It should be noted, however, that the group taking opioids also scored worse in measures of disease severity at the beginning of the study. 

The point seems to be that while all of the patients showed improvement over time regardless of the treatments they received, those receiving opioids did not show greater improvement and in some cases, had less improvement than patients using other standard treatments.  Given the dangers and negative effects associated with chronic opioid use, the study authors advise physicians to be vigilant regarding the continued use of opioids to treat fibromyalgia until more formal clinical trials on opioid use for FM are conducted.




Please Discuss This Article:   Post a Comment 

Opioid use by FM patients
Posted by: Robhab2
Apr 18, 2013
I get furious when I see articles like this. For the last few years there has been a push by the DEA and, as I am told by my doctor, Harvard medical school, to stop treating anyone with chronic pain with medication. Particularly opioids. I have had to switch doctors several times because because my personal physician would come up with fanciful and absurd reasons to stop prescribing drugs, even though they were working quite well.
At first I was puzzled. Why was the medical community all acting so strangely and all in concert? Just three years ago teating pain was the new big field of care. When I got over being angry it became obvious, "the powers that be" was putting pressure on them. They had to decide who's welfare came first theirs or the patent's
What really matters is that there is no cure for FM and there is not likely to be one for many years. Most if not all of today's suffers will die of old age long before a cure is found. So what they become dependant on morphine, it's irrelevant so long as they are receiving some level of pain reduction.
I am not against trying new things, even oddball things. But, don't be stupid. Don't eliminate the one thing that works, just because some people abuse it. Treat each patient as an individual.

Reply Reply

 
Opioid Use in Fibromyalgia
Posted by: 1st*r8
May 8, 2013
Your article is poorly written. It does not tell the reader why fibromyalgia pain is any different than other chronic pain. I've used morphine (30 mg. long-acting) for over 5 years for my chronic fibromyalgia pain. I've gone off it 3 or 4 times during this period to try other medications. Pain is pain. It hurts whether it comes from fibromyalgia, an amputated leg, or cancer. I can tell you, as so many others out there will that morphine and other opioids do work quite well for fibromyalgia pain. You don't even discuss the issue of opioids as being very effective in pain management. You just say that they are not good for fibromyalgia patients. I dare you to prove that opioids do not reduce fibromyalgia pain, thus giving those patients a better quality of life. By the way, I've tried many of your "herbal" treatments, and they're all snake oil!! Cymbalta is supposed to be "THE" greatest thing that ever came along for fibromyalgia. I tried it at the urging of a doctor who I later found out owned stock in it. Cymbalta clouded up my eyes, PERMANENTLY!! Then when I came off Cymbalta due to damage to my precious eyes, the withdrawal was pure hell, much worse than coming off opioids. I was suicidal, homicidal, irritable, sick to my stomach, and lost 8 pounds (I was already at a 119 BMI). This attack on pain patients comes from people freaking out about a few people who become a pain in the neck because they show addictive behaviors and miss use their medications or steal them for recreational use. Why throw the baby out with the bathwater? Why make chronic pain patients suffer for things they are not guilty of? Shame on you for printing this ugly, unhappy, suicide-inducing, hope-robbing article! May you someday suffer with chronic pain, and may you have to live with it without the use of opioids.
1st*r8

 


Doubt results
Posted by: jrbairdmd
May 8, 2013
As I physician specializing in fibromyalgia treatment I am suspect of the conclusions drawn here. I have collected data on over 350 patients with fibromyalgia to assess the outcome of opioids on these individuals. My results demonstrated that 80% of patients reported an improvement in pain relief, quality of life, functional improvement and ability to cope that was over a 60%improvement. Patients were asked what would occur if opioid treatment was stopped and 100% stated they would stay in bed

John R. Baird, MD
Reply Reply
 
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