Clinical research studyOpioid Use, Misuse, and Abuse in Patients Labeled as Fibromyalgia
Section snippets
Methods
From January 2005 to December 2010, all patients referred to the Alan Edwards Pain Management Unit with a referring diagnosis of fibromyalgia were evaluated in a designated fibromyalgia clinic. Patients were referred mostly by primary care physicians, with a few being referred by other specialists; the ongoing clinical care of almost all patients was the responsibility of their primary care physician. Patients were assessed individually by members of a multidisciplinary team that included a
Results
There were 457 patients referred to the fibromyalgia clinic during the study period. All had a referring diagnosis of fibromyalgia. After formal evaluation, 302 (66%) retained a diagnosis of fibromyalgia, whereas 155 (34%) were assigned some other primary diagnosis by the first author, a rheumatologist. Of the 302 fibromyalgia patients, 251 were eligible for entry into a prospective longitudinal cohort study, which is currently in progress. Fibromyalgia patients had a mean pain VAS of 6.4 and a
Discussion
Opioid use for the management of pain in fibromyalgia is strongly discouraged and is not recommended by any current guideline.8, 9, 10 The major finding of this study is that one third of those labeled as fibromyalgia patients and referred to a multidisciplinary pain center were currently using daily opioids, although duration of use is not known. Moreover, those on opioids had indications of poorer health status, with more patients being unemployed, receiving disability benefits, and presented
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2022, Journal of PainCitation Excerpt :However, this is in contrast to other studies that show that individuals taking prolonged opioids show worse psychosocial and physical function.22,29,45 Previous studies have decreased function for individuals with fibromyalgia and prolonged opioid use.22,45 For example, Peng et al, show that individuals with fibromyalgia taking opioid medications demonstrated less improvement in function (Sheehan Disability Scale), depression (PHQ-8), and insomnia (Insomnia severity index) compared to those not taking opioid medications.45
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2022, World NeurosurgeryCitation Excerpt :Conversely, nonmodifiable factors are those that may not be amenable to such change, such as preexisting health conditions and demographics of patients. One identified nonmodifiable risk factor was fibromyalgia, which is a condition associated with chronic body pain, with one study reporting up to one third of patients using opioids and demonstrating drug-seeking behavior.35 This trend, coupled with reports that a majority of patients with fibromyalgia still experience persistent pain following spine surgery,36 may allude to a greater propensity to continue taking opioids postoperatively.
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Funding: Funding for PAS-M was received from the Louise and Alan Edwards Foundation. MAW is supported by the “Fonds de la Recherche en Santé du Québec” and the Louise and Alan Edwards Foundation.
Conflict of Interest: Dr Fitzcharles has received consulting fees, speaking fees or honoraria from Biovail, Janssen, Pfizer, Purdue, and Valeant (less than $10,000). Dr Ware has received consulting fees, speaking fees or honoraria from Janssen, Purdue, and Valeant (less than $10,000). Peter Ste-Marie, Dr Gamsa and Dr Shir declare no conflict of interests.
Authorship: All authors had access to all data and participated in the data compilation, analysis, and writing of the manuscript.