The use of
opioids is becoming a global epidemic, leading to a rise in the occurrence and recognition of the effects of
opioid drugs on the endocrine system. Nonetheless,
opioid-induced endocrinopathies still remain underdiagnosed, mainly because of symptom under-reporting by patients and poor clinician awareness.
Hypogonadism is the most well recognised consequence of
opioid use, but the inhibitory effects of
opioid drugs on the hypothalamo-pituitary-adrenal axis and their negative effects on bone health also require attention.
Hyperprolactinaemia might be detected in
opioid users, but clinically relevant thyroid dysfunction has not been identified. The effects of
opioids on other
hormones have not been clearly defined. Assessment of gonadal and adrenal function (particularly if high index of clinical suspicion of
hypogonadism or
hypoadrenalism) and evaluation of bone health are advised in people that use opiods. Discontinuation or reduction of
opioid dose and appropriate
hormone replacement are the management approaches that should be considered for
hypogonadism and
hypoadrenalism. Further research is needed to facilitate the development of evidence-based guidelines on the diagnosis and optimal management of
opioid-induced endocrinopathies.