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Opioids (Narcotics) for Migraine & Headache Disorders: Two Specialists Weigh In

Opioids are highly controversial in the world of headache medicine. Beyond the obvious issues of dependence and addiction, there are risks specific to headache disorders. In this short video, two headache specialists address some of the issues, including:

  • Taking opioids more than eight times a month puts a person at risk for rebound headache (also called medication overuse headache or MOH).
  • Opioids can reduce the efficacy of other migraine medications, including abortives and preventives.
  • Migraine is an inflammatory condition. Opioids may increase inflammation, counteracting any migraine relief they might provide.
  • Opioids aren’t particularly effective for head pain to begin with. The receptors of the brain associated with head pain have few opioid receptors, so there’s not much for the opioids to work on.

This is a huge, controversial topic, but the more I learn about it, the more convinced I become that opioids should be of limited use in treating headache disorders. Opioids have a place, but that place is small and specific. They shouldn’t be a front line treatment, which they too frequently are.

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The Faces of Migraine Video

You must watch The Faces of Migraine! This incredible six-minute video illustrates the startling statistics of migraine and the profound impact it has on patients’ lives.

Patient advocate Ellen Schnakenberg, her son, and a team of volunteers put together The Faces of Migraine. They’ve done a wonderful job of depicting the harsh realities of migraine. Please watch and share with your loved ones to help spread the word about migraine.

Go to the Faces of Migraine website to share your story or suggest future video projects.

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Headaches 101

Throbbing, pulsing, pounding, stabbing, tightening, squeezing, jabbing, piercing, paralyzing. You may dismiss the pain as a sinus or allergy headache or panic that you have a tumor or a ruptured aneurysm. In either case, the odds are that you have tension-type headache or migraine that doesn’t follow the typical pattern, but you still have to quell the nagging doubt. Besides, whatever your self-diagnosis or fear, headaches are easier to treat the sooner you find their actual cause.

ABC News has some overview videos that can help you understand your headaches better. These links will take you to each video transcript, where there’s an option to view the video.

The National Headache Foundation is a great resource for more detailed headache information.

2/16/10: It is no longer possible to link directly to the videos. You can access the videos by following the link, then searching for the video title.