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Opioid Use in Fibromyalgia: A Cautionary Tale
Don L Goldenberg1, Daniel J Clauw2, Roy E Palmer3
1Department of Medicine, Tufts University School of Medicine, Boston, MA.
Mayo Clinic Proceedings
|March 16, 2016
Summary
Opioids are ineffective for fibromyalgia (FM) treatment, despite common use. Clinical trials show no benefit, and observational studies indicate worse outcomes for patients on opioids, highlighting risks during the opioid crisis.
Area of Science:
- Pain Management
- Pharmacology
- Rheumatology
Background:
- Fibromyalgia (FM) is a chronic pain condition with multiple treatment options.
- Opioid analgesics are frequently prescribed for FM despite questions about their efficacy.
Purpose of the Study:
- To evaluate the evidence for opioid efficacy in fibromyalgia treatment.
- To understand factors contributing to opioid use in FM.
Main Methods:
- Systematic literature search of MEDLINE and Cochrane Library using "opioid AND fibromyalgia".
- Inclusion of articles based on expert opinion and examination of citation lists.
Main Results:
- No clinical trial evidence supports the effectiveness of opioids for FM.
- Observational studies suggest poorer outcomes for FM patients using opioids compared to non-opioids.
- Fibromyalgia treatment guidelines recommend against opioid use.
Conclusions:
- Opioid use in FM is common despite lack of efficacy and guideline recommendations.
- Factors influencing opioid prescription include patient demographics, history, and preferences.
- The continued use of ineffective opioids for FM serves as a warning for other chronic pain conditions, especially given the US opioid crisis.
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