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Pain Research and Treatment
Volume 2013 (2013), Article ID 898493, 7 pages
http://dx.doi.org/10.1155/2013/898493
Clinical Study

Opioid Use in Fibromyalgia Is Associated with Negative Health Related Measures in a Prospective Cohort Study

1Division of Rheumatology, McGill University, Montreal, QC, Canada H3G 1A4
2Alan Edwards Pain Management Unit, Montreal General Hospital, McGill University Health Centre, 1650 Cedar Avenue, Montreal, QC, Canada H3G 1A4
3Faculty of Law, University of Montreal, Montreal, QC, Canada H3C 3J7

Received 9 May 2012; Accepted 18 February 2013

Academic Editor: Muhammad B. Yunus

Copyright © 2013 Mary-Ann Fitzcharles et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

As pain is the cardinal symptom of fibromyalgia (FM), strategies directed towards pain relief are an integral component of treatment. Opioid medications comprise a category of pharmacologic treatments which have impact on pain in various conditions with best evidence for acute pain relief. Although opioid therapy other than tramadol has never been formally tested for treatment of pain in FM, these agents are commonly used by patients. We have examined the effect of opioid treatments in patients diagnosed with FM and followed longitudinally in a multidisciplinary pain center over a period of 2 years. In this first study reporting on health related measures and opioid use in FM, opioid users had poorer symptoms and functional and occupational status compared to nonusers. Although opioid users may originally have had more severe symptoms at the onset of disease, we have no evidence that these agents improved status beyond standard care and may even have contributed to a less favourable outcome. Only a formal study of opioid use in FM will clarify this issue, but until then physicians must be vigilant regarding the multiple adverse consequences of opioid therapy.