Orman Trent Hall, DO: Link Between Fibromyalgia and Opioid Use Disorder

Orman Trent Hall, DO, addiction medicine physician at the Ohio State University Wexner Medical Center, discussed his recent cross-sectional, survey-based study that provided evidence of fibromyalgia as a risk factor for pain-related exacerbation of opioid use disorder.

Pain can be a severe problem for individuals living with opioid use disorder, as chronic pain can have serious consequences for their health, well-being, and safety. Prior research has found that over half of individuals with opioid use disorder suffer from chronic pain, and those in recovery who also have chronic pain are 3 to 5 times more likely to relapse.

“In the age of illicitly manufactured fentanyl, even a single slip up with opioids can be deadly,” Hall explained. “So it's very important to me, as an addiction medicine physician, to make sure that this aspect of their total health is well taken care of.”

However, individuals with opioid use disorder are routinely excluded from new trials for medications to treat pain, leaving physicians like Hall with very little information on what can help them manage their pain.

Recognizing the similarities in risk factors and symptoms between fibromyalgia and opioid use disorder, it's possible that individuals with both conditions might be experiencing more severe symptoms due to overlap. Therefore, investigators hypothesized that individuals with both conditions may be at greater odds of experiencing worsening of their opioid use disorder due to pain compared to those without fibromyalgia.

Investigators recruited 125 individuals with pain and opioid use disorder from a specialty addiction treatment facility in Columbus, Ohio. All participants reported having pain in addition to opioid use disorder and were provided with a series of survey instruments.

Findings indicated that individuals with both fibromyalgia and opioid use disorder were at greater odds of reporting that pain had made their opioid use disorder worse. Specifically, those with fibromyalgia were more likely to report that pain caused them to continue using opioids, to increase the amount of opioids they used over time, to delay getting addiction treatment, and to worry that pain would cause them to relapse in the future.

Although all participants in the sample had pain and opioid use disorder, those with fibromyalgia reported more severe impacts of pain on their opioid use disorder.

This transcript was edited for clarity.