Fibromyalgia increases odds of worsening pain-related opioid use disorder

Key takeaways:

• Patients with fibromyalgia had significantly greater odds of acknowledging pain-related addiction exacerbations.
• A new scale for measuring pain-related exacerbations may help identify at-risk patients.

Patients with fibromyalgia were at greater risk for pain-related exacerbations of opioid use disorder, according to a study published in Pain.

“Fibromyalgia and opioid use disorder are highly burdensome chronic diseases with substantially overlapping psychosocial, neurobiological and clinical features,” Orman Trent Hall, DO, clinical assistant professor of psychiatry and behavioral health at Wexner Medical Center at The Ohio State University, and colleagues wrote.

With limited research on the interaction between fibromyalgia and opioid use disorder (OUD), researchers sought to examine whether fibromyalgia affects the odds of acknowledging pain-related OUD exacerbations in individuals with pain and OUD.

Their observational study recruited 125 adults between July 2021 and December 2021 at Wexner Medical Center’s Talbot Hall, a specialty addition treatment facility. Participants completed the 2011 American College of Rheumatology Fibromyalgia Survey (ACR-FMS), a validated self-report questionnaire that assesses bodily pain and related symptoms, as well as a new four-item Pain-related OUD Exacerbation Scale. Mental health and body pain status also were measured via the Research and Development 36-item health survey (RAND-36).

Results showed all participants reported pain in at least one body region, with lower back pain the most frequently reported (79.2%), followed by neck (36%) and upper back pain (34.4%). The mean number of body regions with pain was 3.69.

Moderate to severe cognitive symptoms, fatigue or feeling unrefreshed upon waking were reported in 46.4%, 65.6% and 69.6% of participants, respectively. Nearly one-third of participants (30.2%) had ACR-FMS scores of at least 13, which met criteria for fibromyalgia.

Further, although all participants reported some type of pain, those with fibromyalgia had significantly greater odds of acknowledging pain-related OUD exacerbations, as reported via the Pain-related OUD Exacerbation Scale and RAND-36. Fibromyalgia also was associated with significantly increased odds of pain-related OUD maintenance (2.31; 95% CI, 1.08-4.92).

“Although additional research is needed, these instruments might be useful for identifying patients at risk of pain-related OUD exacerbations,” Hall and colleagues wrote.