Fibromyalgia and dangers of opioids

The use of opioids treatments in fibromyalgia is known to have far more risk of serious side effects than the benefits of pain relief

Fibromyalgia is a medical condition that causes chronic widespread musculoskeletal pain accompanied by fatigue.

People suffering from fibromyalgia have tender points which hurt when pressure is put on them.

There is no known cause of fibromyalgia but there are various factors that are believed to contribute to the onset of fibromyalgia.

Fibromyalgia affects the muscles and soft tissue. Its symptoms include chronic muscle pain, fatigue, sleep problems, and painful tender points or trigger points.

These symptoms can be relieved through medications, lifestyle change and stress management.

One of the most common or key symptom of fibromyalgia is pain and many go to extreme measures to relieve these pains.

One such common treatment that people suffering from fibromyalgia tend to undertake is the use of opioids, a pain reliever or pain killer.

However, the medical use of opioids has led to series of concerns about its benefits. There are several studies carried out which shows that opioid medication has more negatives than positives.

What are opioids?

Opioids are substances that act on opioid receptors to produce morphine-like effects and are medically used to reduce pain.

It is known to reduce the intensity of pain signals that reach the brain and affect those brain areas controlling emoting that weakens the effects of a painful stimulus.

In 2014, a leading U.S. medical organization has also urged its members not prescribe opioid painkillers to patients suffering from fibromyalgia, low back pain or headaches, because the risk of serious side effects outweighs the benefits of pain relief.

According to a survey of over 2,400 women by the National Pain Report, although opioid pain medications are generally not prescribed for fibromyalgia, nearly 60 percent of women suffering from the condition are found to be taking opioids.

The dangers of using opioids

The Centers for Disease Control and Prevention recently discouraged doctors from prescribing opiates in their new guidelines.

The guideline was a part of a federal response to the increasing rate of opiate addiction in the U.S. Since 1999, more than 165,000 people in the U.S. have died of causes related to painkiller use.

The CDC guidelines note that the deaths have paralleled an enormous increase in the sales of these drugs.

About 250 million painkiller prescriptions were written in 2013, enough, the agency noted,

According to a survey published in the American Journal of Medicine in 2011, 457 Canadian fibromyalgia patients who received opioids, nearly a third of those studied generally fared worse than patients who received no opioids as part of treatment.

A study published in the journal Pain Research and Treatment examined the effect of opioid treatments in patients suffering from fibromyalgia over a period of two years.

According to the study, although opioid users may initially have had more severe symptoms at the onset of the condition, there were no evidences that these agents improved status beyond standard care and may even have contributed to a less favorable outcome.

The study raises its concerns regarding the negative effects associated with chronic opioid use and the rational use of opioid treatments in fibromyalgia patients.

It was observed that one third of the fibromyalgia patients followed longitudinally in a multidisciplinary pain clinic were maintained on opioid drug therapy and over time there was an improvement recorded for the total cohort for measures of pain, function, and mood, irrespective of opioid status.

However, opioid users scored consistently higher for all measures of symptom severity with significance noted for higher pain scores and more functional impairment.

The study reported that while opioids remain a treatment choice for management of pain, patients using opioids failed to show any advantage in overall health status.

Although there are short term benefits of opioid treatments, the long term benefits seem very bleak.

A study on the long-term evaluation of opioid treatment in fibromyalgia was published in the National institutes of Health.

The twelve-month observational study evaluated the effect of opioid use on the outcomes in 1700 adult patients suffering from fibromyalgia.

The study revealed that although pain severity was reduced over time in for all patients, opioid users showed less improvement in pain-related interference with daily living, functioning, depression, and insomnia.

Therefore, the study concluded that overall findings show little support for the long-term use of opioid medications in patients with fibromyalgia given the poorer outcomes.

Types of opioids

There are different types of opioids that many people use. Some are as follows:

  • codeine (only available in generic form)
  • fentanyl (Actiq, Duragesic, Fentora)
  • hydrocodone (Hysingla ER, Zohydro ER)
  • hydrocodone/acetaminophen (Lorcet, Lortab, Norco, Vicodin)
  • hydromorphone (Dilaudid, Exalgo)
  • meperidine (Demerol)
  • methadone (Dolophine, Methadose)

How does Opioids Work?

Opioids attach to specific proteins called opioid receptors that is found in the brain, spinal cord, gastrointestinal tract, and other organs in the body.

When the opioid drugs connect to their receptors, they reduce the perception of pain or reduce the sending of pain messages to the brain and therefore reduce feelings of pain.

Fibromyalgia and dangers of opioids

Opioid Side Effects

Opioids have serious side effects if not managed properly. It is important to understand the side effects that it causes. Some side effects include:

  • Mental confusion
  • Nausea
  • Vomiting
  • Drowsiness
  • Constipation
  • Depress respiration

If opioids medications are not well managed it can lead to serious medical complications including overdose.

It is important to note that opioids can be very dangerous if you take it with alcohol and certain drugs such as some antidepressants, antihistamines, and sleeping pills.

Therefore, it is important to let your doctor know about any kind of medication that you are on before taking opioids medication.

Do not stop or take opioid medication on your own. It is vital that you consult your doctor first.

The use of opioids to treat fibromyalgia has been increasing year after year. It is therefore, important to understand its risks and benefits before getting yourself onto the medication.

41 Comments

    • I was just recently taking 1 a day. My doctor decided to drop down to a lesser dosage, then none! Instead of opiod, I now take a prescription called Butrans (patch) 0.05 for my pain. I love it! Feel blessed no longer taking opioid all the time! Made me feel like i just couldn’t function & side affects.
      Contact ur doctor & mention Butrans & see what they think for you. Good luck & God Bless You!

      • I started with a high dose of oxy 1 every 4-6 hrs for about 6yrs. Then changed to another similar to oxy for 3yrs. Then dropped down to 1-2 a day. My primary finally got me off opiates 2 months ago!

      • I have been weaned off Tramadol (Opiate) after taking it for 3 years. I am experiencing really bad withdrawal symptoms. Just wondering if anyone else experienced problems when coming off them.

        • H E double toothpick yeah! Oh man. It’s been about five or six years now since I was tapered down to nothing and I remember it still quite vividly when I am reminded about it. I was on methadone for almost eight years. One of the bummer parts is how utterly naive I was about it. For some reason it didn’t occur to me that it even WAS an opioid simply because it is well known for helping people come off heroin. I don’t know what I thought it was categorized as, but only thought of it as simply a pain reliever. I was quite put out when I received the letter from my PCP explaining that the medical community had decided it wasn’t considered a good pain killing choice for THE anymore. I was exasperated; wasn’t science, well, a SCIENCE? Science was portrayed as unmovable law in jr and high school.
          Well, shortly before I was scheduled to begin tapering off I ended up going to the ER because I couldn’t get my stomach to stop hurting. They took an EKG because in women that can be a symptom of a heart attack. I found out there was a funny reading, but not a heart attack which when I later read about the side effects of methadone was on the list! Suddenly I was all on!
          I didn’t feel any withdrawal symptoms until I was on my last week of tapering off. Then it hurt like a son of a gun! I couldn’t sleep. Wandering around seemed to be the only thing that helped. At that time my sister and I lived in a house behind my parents animal hospital and I would go there at night, walking, and occasionally sit to use dad’s computer. I, again, was upset. Methadone wasn’t supposed to be an addictable sustance! Even though I knew better, I still allowed myself to dwell on that occasionally! What about you?

      • I too was using the patch…loved it…I could actually function again without hurting 24/7 until it started to have an adverse effect on my skin….the medicinal part of the patch….it was as if it was burning my skin…i was now starting to get a red,rashy,very itchy and perfectly square shaped area that took weeks to heal..doc tried a couple of things before it was determined I could no longer use it…I was devastated to say the least as this was the only thing in a mountain of trial drugs that worked for me…now I have nothing that works left with the pain again that I thought we had finally conquered 😟

        • My husband had the same problem and an old pharmacist suggested using a Flovent Inhaler and puffing the medication on the skin that the patch was going on. Worked like a charm! He too would not have been able to continue using them but now does with no redness/rashes/blisters….unless we miss a spot 🙂

  • What’s about Tramadol? I have FB and OA many years, have tried many medications, now I stopped at Tramadol 150 mg per day + 75mg Lyrica + Cymbalta 100 mg per day.No more,Can I’ll get addictive?Serious side effects?

    • Tramadol was worthless for me, the others you name are way out of my affordability.
      I’ve talked with my Dr about Cannibis (slang name Marijuana), and he is totally against it for the possibility of 2 reasons I’m thinking, he’ll get no kickbacks from drug companies, and I’m told some religions are against as well.
      So here we are, trapped by beliefs and the lack of clearing the prohibition on a God given plant that could help in so many ways, because certain people won’t get kickbacks!

      • Ask for marinol also called dronabinol. It is synthetic THC. Legal in all 50 states. It’s a gel tab that comes in 2.5mg, 5mg, or 10mg. I take 10mg twice a day. Really helps and way safer than oxycontin dependency. It’s a sativa, so gives energy and pain relif. It will also give u the munchies, so watch out for weight gain. Keep in mind u will test positive for THC. As long as a doctor is prescribing it u will be fine. Good luck

    • Any opioid can be addictive. Whether or not you can is hard to say. Has any blood relative had any addiction tendencies? I never heard of any relatives that did, but my family and extended family haven’t touched alcohol for many, many generations, and I haven’t heard of anyone using illegal drugs. The closest I’ve been is to sugar, soda in particular. As for side effects, you might want to ask the pharmacist, or read about tramadol and see what it says about side effects. The med I took has a side effect with a rythum with the heart, and I found out just before I was weaned off it that I had that.

  • I’m in pain everyday from fibro to the point I’m crying can’t sleep feels like I have ants all over my body my feet hurt I don’t like to be touched so if they take away r pain Meds what r we suppose to do suffer for the rest of r lives if I’m up on my feet for an hour r more I pay for it that night and in bed the next day some ppl aren’t all alike I suffer from this I don’t abuse it I need ot for the pain

    • PENNY YOU SOUND JUST LIKE MYSELF. I THINK I,VE BEEN THROUGH EVERY TABLET AVAILABLE,ALL TO NO AVAIL.I,VE RESIGNED MYSELF THAT THIS IS ITFORTHE REST OF MY LIFE AD STRUGGLE FROM DAYTO DAY.

    • Penny,

      My pain is like yours and I’m 35 years old with a 15 year old daughter. I feel so guilty bcuz I can’t do too much of anything and my pain tolerance is so high that my doctors do tests on me to figure out why. I need something to stop all of this pain. What’s the best thing to ask for when you’ve been through a world of trial meds that don’t do Shit for you? I hurt so bad non stop day in and day out.

  • I think Avril raises a good question about alternatives for opioids. They seem like the go-to for pain relief. But other ways to manage pain could include stress reduction, meditation, aromatherapy, progressive muscle relaxation, etc.

    • None of which are going to relieve the severe pain. If meditation takes care of your pain, you don’t have more than a minor ache. Get real!! What a bunch of crap!! FYI, insurance doesn’t pay for alternative therapies like acupuncture, yoga, aromatherapy, etc and these things are not cheap! Why can’t we the patients decide if we are willing to take the risk for the side effects? The medical community preaches “pt centered care” and encourages patients to be involved in planning their care, yet not when it comes to pain management?? Seems just wrong!

      • Totally agree. They are taking away pain meds and leaving us with NOTHING. Real pain needs pain medicine. I have been taking 3 hydrocodone 5mg /day since 1999. I am not pain free BUT I can work (usually 10 hours/day, 5/days week) and I take care of all our other living needs – grocery shopping, light yard work, cleaning, laundry, etc. Before 1999, I did not want to live anymore. I couldn’t take the pain and the exhaustion. When I take a pain pill, I can sometimes feel the pain leaving my body. That is like a miracle to someone in severe pain. If I could not have worked all these years would I have been homeless? Would I have ended my life? What about my kids? My disabled husband? I want a life and I want to live my life. I have been a compliant patient all these years. Why am I being punished?

  • Sorry but I disagree you keep not treating the pain and you watch the suicide rates climb higher and higher. Advil and other snails I tried first ruined my kidneys. We have already tried all the other things before we settle on opiates. All the exercise stress reduction meditation all tried all failed.

  • I take Norco three times daily for pain relief. It helps a lot and allows me to sleep at night. My only issue is I still work 8hrs a day and can’t take the meds until I get off work. Sometimes I’ll take 800mg Ibuprofen at work to substitute. I don’t know what I would do without my pain meds. I would be willing to look into cannabis options in the future.

    • Sorry for very late reply. I have taken opioids and can feel the moisture draining from my body. however, after a spell of not getting any medical marijuana, I opted for more opioids and as the days went on, my mouth became bitter and dry. I felt the need for drinking so much liquid and could feel my liver hurting. eventually, I managed to get some high grade medical marijuana and am feeling much better already. have halved my intake of Cocodomal in one day!. Cannabis sativa is fabulous for relaxing the muscles, easing the pain, ensuring you take your time as you become chilled as well as aiding sleep eventually. It enables you to concentrate and reflect. Not recommended for day unless you are at home doing leisurely things such as cooking and gardening. Very little side effects apart from enjoying the buzz but still being in control and nice to be around as you are able to switch off from pain. Hope it all works out for you.

  • I have opiods available, and have had for years. I only take one on the worst days when I absolutely, positively have to function. My guess is that I maybe take 1 pill every two months. I am obviously not prone to narcotic abuse or addiction and quite frankly, it angers me to be tossed into a category of “potential opioid misuse.” It now takes an Act of God to even get my prescription renewed, which I resent. I understand the doctor’s concern regarding overdose, but someone needs to come up with a better way to control the medications without punishing the group as a whole.

    • Laurie I agree with you I don’t abuse my meds I need them too. But so many do and we have to pay for it. My tells me all the time that the pain meds aren’t helping me. I told him it’s my body and I know that the meds do help me. He doesn’t know. It makes me so mad!!

  • I’m sorry but I’m going to kind of have to disagree with this. I do many things to treat my fibro. First thing I started eating very healthy. Mostly Organic and non GMOs. Replaced sugar with coconut sugar.. Reduced some stress by getting rid of toxic people in my life.. I try to move my body as much as possible of course not overdoing it. I do that by yoga, walking, I do a little roller skating not too extreme. Stretching is pretty important I usually do that before bed. Epsom Salt baths and heating pads are great! I also highly recommend using Mary Jane. It calms your nerves. It keeps you relaxed for the most part. It also works wonderfully for sleep. However, there are times these methods are not enough and I’m in pain. I take 10 milligram Lortab up to twice a day as needed. Nothing more nothing less and it works for me. I have been doing this for the past 3 years now. I tried Lyrica, Cymbalta, Flexeril, Doxipin, Ativan none of that worked for me.. As long as you don’t overdo it and stick to the prescribed amount you should be fine. However, if you have an addictive personality I would not recommend opiates. I can see if you are not disciplined how easy it is for someone to get addicted.. Good luck everyone! I hope my information helps someone! Xoxo

  • These threads seem to usually end up in conversations of “well I can do this and that, I don’t know why you can’t” and that is so discouraging. Fibromyalgia is a diverse as each one of us are. Each one’s level of pain is different and each one’s pain tolerance is just as different, too. Opioids are sometimes the ONLY things that work for some of us. For some of you, yes, stretching and removing toxic people in your life and such, that is so wonderful. For some of you, it is so great that you can take meds and continue to work. Some of us are unable to work because to pain is so intense. You just do not understand the intensity of it. We are basically disabled and are forced to pretend that we are not. And that, in turn, forces us into more pain and depression because we are not understood. Suicide has crossed my mind many times as a way out of pain. Not that I wanted to actually die, but I just maybe didn’t want to exist like this. Fibromyalgia has been the worst health issue I’ve ever had to encounter and I can’t seem to whip it. I’ve whipped many others: obesity, diabetes, a brain tumor, a knee replacement, e-coli, liver abscesses, chronic migraines, but I cannot beat fibromyalgia. Yet. I am determined to win. Some how I WILL find a way to be normal again.

  • I can’t stand to hear that anyone who suffers from this can also bully some into their regime and it worked for them and why the heck aren’t you trying to help yourself? I personally believe each and every person has general symptoms but the degree of them is what is so different. I’m not going to say I suffer more than you. I have tried ALL so called meds for Fibro including off label use, none helped, not even the slightest and came with side effects that were unbearable. I believe the pharmaceutical companies came up with BS meds and maybe a slight 10-20% they might help but the majority it does nothing. I’ve gone the natural route and still do most of them even though I get no relief. Epsom baths, acupuncture and acupressure, watching what I eat, mild exercise, the list goes on. You also have to take into account that most are dealing with multiple health issues. I have CFS, Medullary Thyroid Cancer (not curable and had a left and central neck dissection that I now suffer from nerve damage in my neck, shoulder, and can’t lift my left arm, osteoarthritis, IBS, to name a few. I tried the tens unit but that didn’t help either and physical therapy also did nothing. So for some to say I just got rid of toxic people and exercise is fabulous for you but dont throw everyone to the ground because they haven’t tried it or it didn’t work or that no other pain meds work besides opioids. I am on heavy duty pain meds for all of my pain and I am not an addictive personality I am suffering every second of every day and to function and not want to commit suicide this is what I have to do for now until hopefully one day they find a cure or an actual prescription that works. Until then for most this is a disabling syndrome for others I am curious to know if it may be something that mimics Fibro. I did the blood test for fibromyalgia to confirm this diagnosis. Most dr. Don’t believe in this test but I don’t believe in most doctors, they do not do more than what is taught in medical school unless you see a functional medicine dr. The blood test may be covered under your insurance. Just google the fibromyalgia test. It’s the FM/a test. If you can not go to their labs they will send a nurse out to you.

    • I haveexatly the same symptoms as yourself. I,ve given up on doctors now and have resigned myself that this is how I,m going to be for the rest of my life. Would love to give up my dihydrocodeine forever but when the burning pain is off the rictor scale I,d take arsenic if it would ease my pain. My whole body is on fire, I never need a hot water bottle or electric blanket and am thrilled when myhusband gets into bed with freezing cold feet!! Every bone in my body is on fire from my head to my toes. Even my jaws ache. GPs don’t want to know and won’t even come out to me. Usually ring the surgery what I feel I can,t take any more, but all they do is ring back and tell me to double my dose of painkillers and double my Prozac!!! I also have Glaucoma now and and losing my sight. If opioids help then take them!!

    • Thank you so much for this post. I hurt so much every second I’m not in a deep sleep, although my husband says I cry in my sleep. When and where is the point that opiates can be taken daily, you become addicted, but it let’s you live out your life. No suicide.

      • Eileen I share your despair. You do what your body tells you. If you feel opioids. Help, take them, you,lol soon know if they help or not. Because of my illness my life routine has completely changed, can,t get up early of a morning now. Luckily my husband is here to give me my breakfast in bed and after this I have to take a painkiller which usually puts me to sleep for an hour or so so it,s heading to lunch time before I can get up slowly. I can,t walk outside the house now but try to walk around my small garden. Potter around the house and do what small things I can but always end up n chronic pain, everywhere on fire!! Thank goodness for my TV. If you can,t change your life you have to adapt yourself to the way this horrible illness has directed you to. If others don,t like it then it,s tough, they,re not the ones suffering. My family are used to me now but it took them a long time to do so. I have a good sense of humour with with I,ve been blessed so it,s harder still for others to understand how someone who is in such pain manages to cope. It,s not easy, but as long as they accept me for what I am now helps me beyond belief. Acceptance on all sides is the key word.

    • I could of written this!I think my incurable thyroid cancer an subsequent ops an radiotherapy caused my fibro.my neck an shoulder pain seems to radiate to my head an back etc an I’m always in pain : / …….. no thyroid def doesn’t help with the low moods etc too……. it’s pants!

  • I strongly disagree with this decision by the CDC. They are letting us suffer with nothing to offer in exchange. I’ve been in constant pain for almost three years and my Dr. will not prescribe me pain medication. It is utterly asinine of the medical administration to do this to us. What else are we supposed to do when we adhere to all suggestions and, still, pain….. Thanks a lot to all the drug users and pushers, you’ve ruined a pain relief form for us decent folk….

  • Surprised and relieved to see how many people agree with me. Have just got out of bed and reluctantly come downstairs, after all it is 3.20.pm.!!! What a night, pain, nightmares depression, I despair. Neck, head and jaw pain plus glaucoma and failing eye sight. Anyone got a gun??? Lol. No good calling GP as he doesn’t,t want to know. I honestly feel I will not see another Christmas as no one wants to know but think I,ll hang around and prove them all wrong, lol. Fed up with life, pain, only the fact that I have grandchildren to keep me hanging on. Excuse my ranting just having another bad day.

  • I’ve been been using Butran patches for two weeks but have had no help fro them and also experienced a sore arm where I,d placed the patch. Did nothing at all to help my pain so took it off and threw it in bin yesterday. Was occasionally having to take dihydrcodeine as well to help. Found I was sleeping better but was spending 16 hours a day in bed. I do,t know what more my doctor can do for me.

  • Fibromyalgia is frequently a progressive disorder for which we have no cure. Pain can get worse over time. Thus we should not EXPECT the use of opioids at a steady dose rate to permanently improve function, as the underlying physiological mechanisms (whatever they are) are not moderated by the opioids.

  • Butrans IS an opioid. I used to take it before I began to have a bad reaction and it “ate” up my skin.
    I now have Fetanyl patches. I have a chronically painful kidney- from becoming detached from inside my back, being swollen so long it will always be. (there is more to it than that.) Also have DDD and self-fusing in the neck and btwn the shoulder blades-probably from an old “horse” injury. It causes an all-out war btwn the spine, which won’t move, and the muscles, who insist it does! I am recuperating presently from a 2nd complete knee replacement and in P.T. which makes the FM and chronic migraines and arthritic shoulders much more painful. I take many supplements, take care of 15 acres-not anyway near what I used to-and a veggie garden, barn cats, chickens and a couple dogs. Every day is not the same. I used to do much more with horses, a milk cow and various smaller livestock that I no longer can do. So, I continue to par down the work and the animals I love to be more reasonable for my body, keeping only the easy stuff. Yes, I’m on a couple different pain meds for about 4 years now. When I can, I re-think priorities and try very hard to have a can-do attitude. Just before knee surgery this time I was about ready to give up, really give up, minus suicide. It helps to know my Jesus suffered way more than I ever will and so many of the great Christians who suffered so terribly help with their writings on scripture. I stress about opioid addiction but realize it is a trade off. I get to live a little more comfortably for a probable shorter time. It is enough to be able to be in my husband’s,children’s and grandchildren’s lives while there is time to do so. Without the meds, I may live longer but would return to crying in the closet 24/7.

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