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Opioid Treatment of Migraine: Risk Factors and Behavioral Issues

  • Psychological and Behavioral Aspects of Headache and Pain (D Buse, Section Editor)
  • Published:
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Abstract

Migraine can impact every aspect of a person’s functioning. Psychological comorbidities, cognitive constructs, and behavioral responses to pain greatly impact the perception of migraine pain, treatment efficacy and outcome, and overall quality of life and functioning. Current considerations for migraine treatment emphasize the utility of the biopsychosocial model in understanding and treating migraine, noting both the importance of addressing psychological factors such as cognitive beliefs as well as psychiatric comorbidities. The guidelines for migraine treatment implicate opioid therapy as a second or third tier treatment. Guidelines and recommendations for the safe use of opioid medications among patients with chronic pain emphasize the importance of screening prior to prescribing opioid medications. Chronic opioid therapy has been shown to further levels of disability, decrease quality of life, and correlate to psychiatric comorbidities, concerns that are already present in migraine patients. While opioid treatment provides an alternative for persons with contraindications for alternative migraine treatments, it is critical that opioids be used sparingly and exclusively in conjunction with comprehensive assessment and integration of psychological treatment.

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Author information

Authors and Affiliations

  1. Integrated Behavioral Associates, 169 Libbey Parkway, Weymouth, MA, 02189, USA

    Melissa T. Stone

  2. South Shore Medical Center, 143 Longwater Drive, Norwell, MA, 02061, USA

    Melissa T. Stone

  3. Boston PainCare Center, Waltham, MA, USA

    Valerie Weed

  4. Tufts School of Medicine, Waltham, MA, USA

    Valerie Weed

  5. Shriners Hospital for Children-Boston, 85 First Avenue, Waltham, MA, 021451, USA

    Valerie Weed

  6. Dept. of Diagnostic Sciences, Craniofacial Pain, and Headache Center, Tufts University School of Dental Medicine, Boston, MA, USA

    Ronald J. Kulich

  7. Lecturer in Anesthesia, Critical Care and Pain Medicine/Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, 1 Kneeland Street, Boston, MA, 02111, USA

    Ronald J. Kulich

Authors
  1. Melissa T. Stone
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  2. Valerie Weed
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  3. Ronald J. Kulich
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Correspondence to Melissa T. Stone.

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Melissa Stone, Valerie Weed, and Ronald J Kulich declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Psychological and Behavioral Aspects of Headache and Pain

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Stone, M.T., Weed, V. & Kulich, R.J. Opioid Treatment of Migraine: Risk Factors and Behavioral Issues. Curr Pain Headache Rep 20, 51 (2016). https://doi.org/10.1007/s11916-016-0581-9

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  • DOI: https://doi.org/10.1007/s11916-016-0581-9

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