Among several opioid-associated endocrinopathies, opioid-associated adrenal insufficiency (OIAI) is both common and not well understood by most clinicians, particularly those outside of endocrine specialization. OIAI is secondary to long-term opioid use and differs from primary adrenal insufficiency. Beyond chronic opioid use, risk factors for OIAI are not well known. OIAI can be diagnosed by a variety of tests, such as the morning cortisol test, but cutoff values are not well established and it is estimated that only about 10% of patients with OIAI will ever be properly diagnosed. This may be dangerous, as OIAI can lead to a potentially life-threatening adrenal crisis. OIAI can be treated and for patients who must continue opioid therapy, it can be clinically managed. OIAI resolves with opioid cessation. Better guidance for diagnosis and treatment is urgently needed, particularly in light of the fact that 5% of the United States population has a prescription for chronic opioid therapy.

A closer look at opioid-induced adrenal insufficiency. A narrative review / Coluzzi, Flaminia; Lequang, Jo Ann K.; Sciacchitano, Salvatore; Scerpa, MARIA SOLE; Rocco, Monica; Pergolizzi, Joseph. - In: INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES. - ISSN 1422-0067. - 24:5(2023), pp. 1-16. [10.3390/ijms24054575]

A closer look at opioid-induced adrenal insufficiency. A narrative review

Flaminia Coluzzi
Conceptualization
;
Salvatore Sciacchitano
Writing – Original Draft Preparation
;
Maria Sole Scerpa
Data Curation
;
Monica Rocco
Writing – Review & Editing
;
2023

Abstract

Among several opioid-associated endocrinopathies, opioid-associated adrenal insufficiency (OIAI) is both common and not well understood by most clinicians, particularly those outside of endocrine specialization. OIAI is secondary to long-term opioid use and differs from primary adrenal insufficiency. Beyond chronic opioid use, risk factors for OIAI are not well known. OIAI can be diagnosed by a variety of tests, such as the morning cortisol test, but cutoff values are not well established and it is estimated that only about 10% of patients with OIAI will ever be properly diagnosed. This may be dangerous, as OIAI can lead to a potentially life-threatening adrenal crisis. OIAI can be treated and for patients who must continue opioid therapy, it can be clinically managed. OIAI resolves with opioid cessation. Better guidance for diagnosis and treatment is urgently needed, particularly in light of the fact that 5% of the United States population has a prescription for chronic opioid therapy.
2023
opioids; adrenal insufficiency; chronic pain; endocrine; adrenal crisis; pituitary; hypothalamic-pituitary-adrenal axis; opioid use disorder
01 Pubblicazione su rivista::01g Articolo di rassegna (Review)
A closer look at opioid-induced adrenal insufficiency. A narrative review / Coluzzi, Flaminia; Lequang, Jo Ann K.; Sciacchitano, Salvatore; Scerpa, MARIA SOLE; Rocco, Monica; Pergolizzi, Joseph. - In: INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES. - ISSN 1422-0067. - 24:5(2023), pp. 1-16. [10.3390/ijms24054575]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1673488
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