The Endocrine Society has released a new Scientific Statement today that draws attention to the gaps in research concerning the adverse effects of opioid usage on the endocrine system.
Opioid use and abuse is an escalating global issue. While opioids are prescribed to relieve pain in individuals with cancer or other medical conditions (such as post-injury or post-surgery), they carry a high risk of addiction, potentially leading to opioid use disorder (OUD). According to the World Health Organization, there were approximately 125,000 opioid overdose deaths in 2019.
The repercussions of opioid use and misuse negatively affect hormonal regulation, potentially causing complications in reproductive, bone, and adrenal health.
“Exogenous Opioids and the Human Endocrine System: An Endocrine Society Scientific Statement,” evaluates research related to both the use and misuse of opioids and their impacts on the endocrine system. This Statement focuses on recent studies that analyze the clinical ramifications of opioids, particularly concerning the hypothalamic-pituitary axis and bone health.
“This Scientific Statement addresses numerous research gaps related to the effects and clinical impacts of opioids on the endocrine system,” stated lead author Niki Karavitaki, M.Sc., Ph.D., F.R.C.P. from the University of Birmingham and Birmingham Health Partners in the U.K. “By shedding light on recent findings regarding how opioid use affects gonadal, bone, and adrenal health, we aim to enhance the endocrine well-being of individuals using or misusing opioids globally.”
The Statement reviews the effects of opioids on gonadal and adrenal functions, as well as bone health. The authors identify male hypogonadism, characterized by low testosterone, as a commonly acknowledged side effect of opioid use, and they delve into the lesser-known impacts opioids have on other components of the hypothalamic-pituitary system and bone density. They also explore the connection between opioids and hyperprolactinemia and stress that further investigation is critical for understanding their influence on secondary adrenal insufficiency.
The authors also evaluated how opioid use affects the secretion of specific hormones to clarify the link between opioids and endocrine disorders. These hormones encompass growth hormone, arginine vasopressin (which regulates water balance in the body), and oxytocin (important during childbirth).
In addition, they examined the effects of opioids on bone metabolism, noting their detrimental impact on bone mineral density and the heightened risk of fractures.
“Healthcare providers must be cognizant of these potential endocrine health issues and closely observe patients using opioids for any related signs and symptoms,” Karavitaki added.
Contributors to this statement include experts Jeffrey Bettinger from Saratoga Hospital Medical Group in New York; Nienke Biermasz of Leiden University Medical Center in the Netherlands; Mirjam Christ-Crain from the University Hospital Basel in Switzerland; Monica Gadelha from the Universidade Federal do Rio de Janeiro in Brazil; Warrick Inder from Princess Alexandra Hospital and the University of Queensland in Australia; Elena Tsourdi from Technische Universität Dresden in Germany; Sarah Wakeman from Massachusetts General Hospital, Mass General Brigham, and Harvard Medical School; and Maria Zatelli from the University of Ferrara in Italy.
The complete statement, titled “Exogenous Opioids and the Human Endocrine System: An Endocrine Society Scientific Statement,” can be found published online in the Society’s journal, Endocrine Reviews.
The Endocrine Society creates Scientific Statements to investigate the scientific foundations of hormone-related diseases and conditions, discuss practical applications of this knowledge, and identify areas that need more research. Topics are chosen based on their significant emerging scientific relevance. These Statements are formulated by a Task Force of experts selected by the Endocrine Society, with an internal review by relevant committees and expert external reviewers, followed by an open comment period for all Society members.
