Journal of opioid management
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Review Case Reports
The endocrine effects of long-term oral opioid therapy: a case report and review of the literature.
The negative effects of long-term opioid administration on the body's endocrine system have been known for decades. These effects have been observed and studied with the use of intrathecal opioids and in heroin addicts. However, they have also been noted to occur with the use of oral opioids, especially in those patients who require chronic opioids for the management of nonmalignant and cancer-associated pain. ⋯ If symptoms of endocrine dysfunction are recognized during chronic opioid therapy, appropriate evaluation, treatment, and follow-up should be instituted. This article describes a case report of a patient who suffered from a clinically significant testosterone deficiency and osteoporosis related to the use of long-term oral opioids for chronic nonmalignant pain. It also includes a review of the existing literature regarding OPIAD and provides recommendations regarding the evaluation and management of OPIAD.