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Adverse Childhood Experiences and Medication Overuse Headache: Burden and Treatment Impact

Claire H Sandoe1, Valerie Lawler1, Suvendrini Lena1

  • 1Centre for Headache, Women's College Hospital, University of Toronto, Toronto, ON, Canada.

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
|November 14, 2022
PubMed

Insights

Adverse childhood experiences (ACEs) increase the risk of chronic migraine and medication overuse headache (MOH). Patients with ACEs experienced worse outcomes, including higher opioid overuse and disability, highlighting the need for specialized care.

Area of Science:

  • Neurology
  • Psychiatry
  • Public Health

Background:

  • Adverse childhood experiences (ACEs) are linked to chronic pain conditions.
  • Medication overuse headache (MOH) risk factors are not fully understood, with potential links to substance use.
  • Opioid overuse may be a significant risk factor for MOH development or progression.

Purpose of the Study:

  • To investigate the prevalence and impact of ACEs in patients diagnosed with MOH.
  • To explore the association between ACEs and specific risk factors for MOH, such as opioid overuse.
  • To assess the effect of ACEs on headache-related disability and treatment outcomes in MOH patients.

Main Methods:

  • Retrospective chart review of 68 patients diagnosed with MOH.
  • Assessment of ACEs history through patient records.
  • Comparison of baseline and follow-up data including Migraine Disability Assessment (MIDAS) scores and monthly headache days.
  • Analysis of medication overuse patterns, particularly opioid use.

Main Results:

  • Over half (54.4%) of the included MOH patients reported a history of ACEs.
  • No significant differences in baseline disability (MIDAS) or headache frequency were observed between patients with and without ACEs.
  • Patients with ACEs showed a higher prevalence of opioid overuse.
  • Despite similar headache frequency, patients with ACEs reported worse headache-related disability at follow-up.

Conclusions:

  • ACEs are common in patients with MOH and are associated with increased opioid overuse and poorer outcomes.
  • The findings suggest that ACEs significantly impact the course and management of MOH.
  • Patients with a history of ACEs require comprehensive, multidisciplinary treatment approaches for MOH.
Keywords:
Headacheadverse childhood experiencesmedication overuse headache

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