An Overlooked Sequela of Long-Term Opioid Analgesic Use: A Case Report on Central Adrenal Insufficiency

The document presents a case of opioid-induced adrenal insufficiency (OIAI), a condition often overlooked in chronic opioid users. The case involves a 53-year-old African American female who had been using Norco for chronic pain for 2 years and presented with symptoms such as fatigue, weakness, and low blood pressure. Laboratory findings confirmed adrenal insufficiency, and other causes were ruled out, leading to the diagnosis of OIAI. The patient improved after receiving hydrocortisone replacement therapy and reducing her opioid dose. The document concludes that OIAI, which can impair patients' quality of life and lead to an adrenal crisis, is a significant condition that clinicians should be aware of, especially given the ongoing opioid epidemic. The estimated prevalence of OIAI ranges from 9% to 29% depending on the daily dosage and total duration of opioid use.