What is a consequence of chronic opioid therapy for adrenal function?

Chronic opioid therapy can lead to reduced adrenal hormone production due to the impact opioids have on the hypothalamic-pituitary-adrenal (HPA) axis. Opioids can inhibit the release of corticotropin-releasing hormone (CRH) and adrenocorticotropic hormone (ACTH), which are vital for stimulating the adrenal glands to produce hormones like cortisol. This suppression can result in lower levels of cortisol and other adrenal hormones, thereby leading to various clinical manifestations associated with adrenal insufficiency.

In contrast, other possible consequences, such as increased production of adrenal hormones or normal adrenal function, would not align with the known physiological effects of sustained opioid use. Complete adrenal failure, while a severe condition, is less common and typically requires a more drastic disruption of the endocrine system than what occurs with chronic opioid therapy alone.