Headache Treatment in Addiction

Abstract

AbstractThis chapter explains headache treatment in addiction. Opioids are occasionally effective as adjunctive treatment in the setting of acute migraine, but their use as a regular abortive treatment is limited, particularly in cases in which there are medication addiction concerns. Although there may be some benefit to adding them to other analgesic/abortive agents in very select cases of headache patients, regular use of opioids for headaches often leads to abuse and, at the very least, tolerance and increasing doses. Diverting opioids for the purpose of illicit selling for profit is an increasing problem as well. When opioid use is considered reasonable and necessary, strict limits on amounts should be set. Patients should also sign an opioid medication contract that includes the agreement to undergo polydrug testing on a regular basis. In patients with known prior substance abuse, opiates should always be avoided.