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Opioid-induced endocrinopathy (OIE) is a complication of chronic opioid treatment. [ 1 ] [ 2 ] [ 3 ] It is a common name for all hypothalamo-pituitary axis disorders, which can be observed mostly after long term use of opioids, both as a treatment and as a substance of abuse .
Men are at higher risk for opioid use and dependency than women, [201] [202] and men also account for more opioid overdoses than women, although this gap is closing. [201] Women are more likely to be prescribed pain relievers, be given higher doses, use them for longer durations, and become dependent upon them faster.
Opioid-induced hyperalgesia (OIH) or opioid-induced abnormal pain sensitivity, also called paradoxical hyperalgesia, is an uncommon condition of generalized pain caused by the long-term use of high dosages of opioids [1] such as morphine, [2] oxycodone, [3] and methadone. [4] [5] OIH is not necessarily confined to the original affected site. [6]
The opioid epidemic took hold in the U.S. in the 1990s. Percocet, OxyContin and Opana became commonplace wherever chronic pain met a chronic lack of access to quality health care, especially in Appalachia. The Centers for Disease Control and Prevention calls the prescription opioid epidemic the worst of its kind in U.S. history.
Evidence suggests that mental health can be a significant facilitator for opioid abuse. [28] Given that opioids are prescribed for pain management, mental health disorders, such as depression, have been shown to increase use of opioids when treating conditions associated with chronic pain. [28]
Opioids are commonly used for patients who are undergoing cancer treatment, chronic pain and postoperative pain. [4] Although these drugs are suitable for treatment, in long term patients or a misuse of these drugs can increase the risk of toxicity, sleep apnea, abnormal decrease to pain tolerance. [ 5 ]
Buprenorphine, sold under the brand name Subutex among others, is an opioid used to treat opioid use disorder, acute pain, and chronic pain. [18] It can be used under the tongue (sublingual), in the cheek (buccal), by injection (intravenous and subcutaneous), as a skin patch (transdermal), or as an implant.
Non-opioid treatment of chronic pain with pharmaceutical medicines might include acetaminophen (paracetamol) [45] or NSAIDs. [46] Various other nonopioid medicines can be used, depending on whether the pain is a result of tissue damage or is neuropathic (pain caused by a damaged or dysfunctional nervous system).