Why Opioids May Not be the Best Choice for Fibromyalgia Pain

Some patients who suffer from fibromyalgia have tried opioids to alleviate their pain with little success. Others state that their doctors are reluctant to prescribe opioids for their pain due to addiction concerns. In either case, opioids may not be the best choice for treating fibromyalgia pain. Why? A study from the University of Michigan Health System found that people with fibromyalgia may not respond in the expected way to this class of pain medication.

Opioids are a class of drugs referred to as narcotic pain relievers. They work by binding to receptors present in the brain, spinal cord and GI tract (gastrointestinal tract). When opioids bind to these receptors, they block the sensation of pain. Examples of drugs in this class include Morphine, Darvocet, Codeine, and Oxycodone (Oxycontin, Percocet).

Using a special type of MRI (PET scan, or positron emission tomography), researchers were able to demonstrate that individuals with fibromyalgia, who were sex and age matched with individuals without fibromyalgia, have decreased receptor availability in the brain. This means that these individuals’ brains lack the ability to process and diminish pain signals. This is one possible explanation as to why certain people with fibromyalgia don’t get the relief they should from opioids.

Many physicians have been slow to accept fibromyalgia as a real condition causing real pain. Part of the reason for the reluctance to embrace fibromyalgia as a real condition may be due to the fact that patients who are prescribed opioids fail to respond to them as physicians expect them to. They may require higher doses that other people without fibromyalgia, or may complain that the prescribed opioids does not relieve their pain adequately. This phenomenon may cause some physicians to believe that certain patients are drug seeking when, in fact, they are simply not getting adequate pain relief from the medication prescribed, which in “normal” people would be more than adequate to relive pain.

The study was a small one, including 34 individuals, 17 of whom had fibromyalgia and 17 who did not have the condition. This study, although small, points to the need for further study on the effects of opioids in people suffering from fibromyalgia. It also points to a real need for studies of other classes of drugs which may be more effective in treating the condition.

Source: University of Michigan Health System (2007, October 3). Why Don't Painkillers Work For People With Fibromyalgia? ScienceDaily.