New research from The Ohio State University Wexner Medical Center and University of Michigan suggests that individuals with fibromyalgia who also struggle with opioid use disorder (OUD) may be at greater risk for worsening addiction. The study, published in the journal Pain, indicates that the chronic pain associated with fibromyalgia could make it more difficult for individuals to overcome OUD.
The Connection Between Chronic Pain and Opioid Addiction
It is well-established that chronic pain and opioid addiction are closely linked. Many individuals first turn to opioids to alleviate pain symptoms, and chronic pain has been identified as a risk factor for developing OUD. Moreover, individuals in recovery from opioid addiction often experience pain as a trigger for relapse.
However, the new research suggests that not all pain conditions have the same effect on OUD. Researchers suspected that fibromyalgia, a condition that causes widespread pain, fatigue, and cognitive difficulties, might be particularly problematic for individuals with OUD.
Fibromyalgia and OUD: The Double Hit Hypothesis
The study’s lead author, Dr. O. Trent Hall, explained the rationale behind the research: “Many of the brain pathways and chemicals believed to be involved in fibromyalgia are also involved in opioid addiction. This overlap made us suspect fibromyalgia might worsen OUD. It's sort of a double hit hypothesis."
To test this hypothesis, the researchers surveyed 125 individuals who were living with pain and OUD. Of these, 39 (31%) met criteria for fibromyalgia. Participants with fibromyalgia were much more likely to report that pain had worsened their addiction. They also reported greater fears that pain might cause relapse in the future.
Fears About Pain May Delay Addiction Treatment
Dr. Julie Teater, the study’s co-author and medical director of addiction medicine at Ohio State Wexner Medical Center, emphasized the significance of these findings: “Worries about pain may cause people with fibromyalgia and OUD to delay getting addiction treatment. In our current overdose crisis, every day a person puts off OUD treatment might be the last day of their life.”
Dr. Daniel J. Clauw, the study’s senior author and director of the Chronic Pain and Fatigue Research Center at the University of Michigan, noted that the findings suggest new approaches to treating chronic pain and OUD may be necessary. “It's possible that combining lessons learned from years of studying fibromyalgia might one day inform new treatments for chronic pain and OUD,” he said.
More Research Needed
The study’s authors stressed that more research is needed to better understand the relationship between fibromyalgia and OUD. Nevertheless, the findings point to a need for more targeted approaches to treating pain and addiction.
Craig Bryan and Dr. K. Luan Phan from Ohio State also contributed to the research.
Journal Information: Orman Trent Hall et al, Fibromyalgia predicts increased odds of pain-related addiction exacerbation among individuals with pain and opioid use disorder, Pain (2023). DOI: 10.1097/j.pain.0000000000002878
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