Photo Credit: iStock.com/Ivan-balvan

The following is a summary of “Opioid Therapy in Chronic Pain: Assessment of Clinical Outcomes and Relationships With Endocrine Biomarkers,” published in the April 2025 issue of European Journal of Pain by Abou-Kassem et al. 

Long-term opioid treatment (L-TOT) potentially resulted in consequences mediated by factors affecting functionality and health-related QoL. 

Researchers conducted a retrospective study to examine the associations between L-TOT and clinical outcomes, and to explore the mediating role of endocrine biomarkers in individuals with chronic non-cancer pain (CNCP). 

They carried out a cross-sectional study involving 82 adults with CNCP, dividing them into 2 groups: opioid-treated (n = 38) and untreated controls (n = 44). Linear regression analyses were performed to evaluate the associations between L-TOT, outcome measures, and the mediating roles of endocrine biomarkers. A bootstrap method with 95% CI was used to estimate the natural indirect effect. 

The results showed that the opioid group had poorer sleep quality (P= 0.018), physical functioning (P= 0.0186), social functioning (P= 0.002), and higher pain intensity (P< 0.001) compared to controls. Men in the L-TOT group had worse outcomes for the same variables, as well as for anxiety (P= 0.028), depression (P= 0.040), role physical (P= 0.038), role emotional (P< 0.001), fatigue (P= 0.019), and emotional well-being (P= 0.001). The relationship between L-TOT and anxiety in men was significantly mediated by total testosterone (β = 1.6, Bias-Corrected Bootstrap 95%CI: 0.1; 4.1, P= 0.045). 

Investigators concluded that patients with CNCP on L-TOT exhibited significantly poorer outcomes than controls, with testosterone mediating anxiety in men, suggesting potential endocrine effects of opioids warranting further investigation. 

Source: onlinelibrary.wiley.com/doi/10.1002/ejp.70027