Endocrine dysfunction induced by treatment with opioids

Abstract

Opioids have been widely used for the management of acute and chronic pain, but they present several adverse effects such as fatigue, itching, nausea, and constipation. Recently it has been reported that chronic use of opioids has an influence on the endocrine system in humans. The most common endocrine dysfunction is hypogonadism, leading not only to a decrease in sexual function, but also to impaired physical and psychological conditions such as fatigue, muscle weakness, and depression. On the other hand, it has been reported that adrenal insufficiency and adult growth-hormone deficiency can also occur. These endocrine dysfunctions not only lead to impaired quality of life, metabolic abnormality, and organ damage, but they also may induce lethal conditions. Furthermore, these adverse effects can be avoided by either stopping or decreasing opioid treatment or by undertaking hormone replacement therapy. Taken together, it is very important for pain physicians to consider endocrine dysfunctions during long-term treatment with opioids.