Migraines, CDH, and long-term opioids?

• There's a very real possibility that frequent use of opioids are making matters worse, not better, by causing medication over use headache (MOH), aka rebound headaches. For more information on this see Medication Overuse Headache: When the Remedy Backfires. Being in that cycle of medication overuse can also keep preventive medications from having a chance to work.
• Medication overuse is also very frequently a factor in Transformed Migraine, which is when episodic Migraines "transform" to a situation of daily headaches punctuated with debilitating Migraine attacks. Please see Stopping Medication Overuse Can Halt Transformed Migraine and Transformed Migraine - Risk Increased by Some Medications.
• Frequent use of opioids can also lead to changes in the way the brain processes pain, and over time, medications are less and less effective.

One of the best methods of starting to get intractable Migraines or CDH under control is IV infusion to break the cycle. There are several medications that can safely be used this way, preparing the way for developing preventive regimens that can work for you. There's information on this in IV Treatment of Refractory Migraines.

As for preventives, there are now over 100 medications in use for Migraine and headache prevention, let alone countless combinations of them, so it's literally impossible to have tried everything for prevention. You can find a list of these medications in Migraine preventive medications - too many options to give up!

The bottom line, Megan is that the opioids are a very short-term solution to a long-term problem, and they're quite possibly making the problem worse. We understand that you have a young child to care for. Trust us, you're not going to find more time to seek treatment and take care of yourself as she gets older. The time may be spent differently, but she's going to continue to be the center of your universe. The sooner you get working on a preventive regimen, the sooner you'll not only have more time for her, you'll both enjoy it more.

Good luck to you and your family!
John Claude Krusz and Teri Robert

About Ask the Clinician:

Dr. Krusz is a recognized expert in the fields of headache and Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Krusz or more about Teri Robert.

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