opioids

Acute Opioid Use Worsens Outcomes Among Patients With Migraine

PHILADELPHIA—Acute opioid use is still common among patients with migraine despite recommendations against its use, according to new research presented at the American Headache Society’s 61st Annual Scientific Meeting.

The research was led and presented by Todd Schwedt, MD, MSCI, who is the chair of Neurology Research and an associate professor of neurology at Mayo Clinic in Phoenix, Arizona.

To better understand the variables associated with opioid use among patients with migraine, Dr Schwedt and colleagues analyzed responses from the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study survey.

US-based respondents with migraine were identified using International Classification of Headache Disorders, 3rd Edition criteria. The demographics, attack frequency, treatment choices, headache-related disability, and comorbidities were compared between self-reported opioid users with non-opioid users.

Overall, 2388 respondents with migraine were currently using acute prescriptions for headache. Of those, 867 respondents (36.3%) were using opioids.

Results of the analysis showed significantly elevated rates of the following factors among opioid users:

  • Monthly headache days
  • Frequency of emergency care use for headache within 6 months
  •  Frequency of medication overuse
  • Presence of allodynia, depression, anxiety, and cardiovascular morbidity
  • Total pain index (TPI) scores
  • Diabetes diagnoses

Compared with non-users, opioid users were more likely to be men and tended to have a higher body mass index (BMI), allodynia, more frequent headache days, higher TPI scores, anxiety and/or depression, one or more cardiovascular comorbidity, and more frequent emergency care visits.

“Despite recommendations against it, opioid use is common among respondents using prescription medication and is generally associated with markers of worse health, including elevated BMI, TPI, CV, and psychiatric comorbidities, and frequency of emergency facility use for headache,” the researchers concluded.

“Modifiable variables associated with opioid use include presence/absence of physician diagnosis of migraine and greater monthly headache days.”

—Amanda Balbi

Reference:

Schwedt T. Demographics, headache characteristics, and other factors associated with opioid use in people with migraine: results from the chronic migraine epidemiology and outcomes study. Paper presented at: American Headache Society 61st Annual Scientific Meeting; July 11-14, 2019; Philadelphia, PA.