According to a research paper published by Hall et al in the journal PAIN, pain associated with fibromyalgia is a risk factor for the worsening of existing opioid use disorder. Researchers surveyed 125 patients with a history of pain and opioid use disorder recruited from an academic substance use treatment facility using the American College of Rheumatology Fibromyalgia Survey and a novel scale; 39 of those patients met criteria for fibromyalgia diagnosis. The subset of patients with co-occurring fibromyalgia and opioid use disorder were more likely to strongly agree with the following statements: “Pain is a major reason why I have kept using opioids,” “I find myself needing more and more opioids to control my pain,” “I have put off getting treatment for opioid use disorder because I am afraid my pain will be worse when I stop using opioids,” and “I am worried pain will cause me to relapse in the future.” Based on the research in this study, investigators have also introduced a new four-item tool called the Pain-related OUD Exacerbation Scale (PrOUD ES), which may be used in the future to measure patient-reported outcomes. The study authors wrote, “[The] American College of Rheumatology Fibromyalgia Survey and PrOUD ES may be considered for use as patient-reported outcome measures in opioid use disorder research…. Although additional research is needed, these instruments might be useful for identifying patients [with fibromyalgia] at risk of pain-related opioid use disorder exacerbations.”
In a companion press release on the findings from The Ohio State University Wexner Medical Center, study coauthor Julie Teater, MD, Medical Director of Addiction Medicine at Wexner Medical Center, said, “These are serious findings. Worries about pain may cause people with fibromyalgia and opioid use disorder to delay getting addiction treatment. In our current overdose crisis, every day a person puts off opioid use disorder treatment might be the last day of their life.”