In the thick of a migraine attack, the strongest painkiller sounds the most appealing. Anything to alleviate the pain. But the very strongest class of painkillers there is, opioids, don’t effectively treat migraine pain, researchers say. An abstract published in the journal Headache found opioids could even worsen migraine pain, turning occasional attacks into more frequent episodes.
“Use of opioids in migraine is pennywise and pound foolish,” the abstract reads.
This increased frequency, known as transformed migraines, involves less severe headaches that occur as often as daily. Overmedication is believed to contribute to transformed migraines, while as many as 80% of people with transformed migraines overmedicate, according to the National Headache Foundation.
Resist the lure of opioids for treating migraines. Researchers say the drugs can worsen pain in the long term.
Long-term opioid use is believed to change pain-related pathways in the brain, making people more sensitive to pain whenever they reduce dosages of the medication.
Just how drastically do opioids affect migraine progression? A study from the American Academy of Neurology found people with migraines who took opioids or barbiturates, another dangerous class of drugs, as few as 8 days each month were twice as likely to develop chronic headaches as migraine sufferers who didn’t take the pills.
The Michigan Headache and Neurological Institute completed a 5-year study of chronic headache patients who took opioids, and found that fewer than 25% experienced relief from taking the pills. The patients who did experience benefits still continued to take other headache medications; plus, those patients ended up demonstrating warning signs of misuse, including changing their dosages without doctor approval.
Opioids and migraines don’t mix: the Food and Drug Administration has not approved the pills to treat the condition.
Some doctors prescribe opioids “off-label,” meaning they prescribe the drug to help with migraines even though it’s not an officially approved choice, according to the University of Maryland Medical Center. However, this typically only happens in the very worst cases where patients have tried other drugs without relief.
General risks of taking opioids include addiction and drug tolerance, where the body becomes accustomed to the pills. This results in higher doses needed to achieve the same pain-relieving effect.
Have you ever taken an opioid to alleviate migraine pain?
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