Opioid-induced endocrinopathies

Research output: Contribution to journalArticle

Authors

Colleges, School and Institutes

External organisations

  • Birmingham Health Partners
  • University Hospitals Birmingham NHS Foundation Trust
  • Western University

Abstract

The use of opioids is becoming a global epidemic, leading to a rise in the occurrence and recognition of the effects of opioid drugs on the endocrine system. Nonetheless, opioid-induced endocrinopathies still remain underdiagnosed, mainly because of symptom under-reporting by patients and poor clinician awareness. Hypogonadism is the most well recognised consequence of opioid use, but the inhibitory effects of opioid drugs on the hypothalamo–pituitary–adrenal axis and their negative effects on bone health also require attention. Hyperprolactinaemia might be detected in opioid users, but clinically relevant thyroid dysfunction has not been identified. The effects of opioids on other hormones have not been clearly defined. Assessment of gonadal and adrenal function (particularly if high index of clinical suspicion of hypogonadism or hypoadrenalism) and evaluation of bone health are advised in people that use opiods. Discontinuation or reduction of opioid dose and appropriate hormone replacement are the management approaches that should be considered for hypogonadism and hypoadrenalism. Further research is needed to facilitate the development of evidence-based guidelines on the diagnosis and optimal management of opioid-induced endocrinopathies.

Details

Original languageEnglish
Pages (from-to)68-80
Number of pages13
JournalThe Lancet Diabetes and Endocrinology
Volume8
Issue number1
Early online date14 Oct 2019
Publication statusPublished - Jan 2020