What condition may develop due to long-term opioid use?

Long-term opioid use can lead to adrenal insufficiency due to the impact of opioids on the hypothalamic-pituitary-adrenal (HPA) axis. Opioids can suppress the secretion of adrenocorticotropic hormone (ACTH), which in turn affects cortisol production in the adrenal glands. This suppression can result in insufficient levels of cortisol, a hormone crucial for stress response, metabolism, and maintaining homeostasis in the body. Patients with adrenal insufficiency may experience symptoms such as fatigue, weakness, weight loss, and hypotension.

The other conditions mentioned, such as cardiac arrhythmias and respiratory distress syndrome, are not typically associated with prolonged opioid use in the same direct manner as adrenal insufficiency. While chronic insomnia can be a concern for individuals with pain or substance use disorders, it is not as directly linked to the physiological changes caused by long-term opioid therapy as adrenal insufficiency is.