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Abstract Details

Opioid Use, Disability, and Cognition in Migraine: Multi-Country Results From the Chronic Migraine Epidemiology and Outcomes – International Study
Headache
S35 - Hot Topics in Headache (2:36 PM-2:48 PM)
009

Opioids are not recommended for the acute treatment of migraine because of limitations in efficacy and safety.

To contrast disability and cognitive function in people with migraine who do and do not use opioids to treat their migraine in the Chronic Migraine Epidemiology and Outcomes-International (CaMEO-I) Study. 
CaMEO-I was a cross-sectional, web-based survey conducted from 2021-2022 in six countries.  Opioid use was based on self-reported use or possession over the previous 30 days.  Treatment optimization and disability were measured with the Migraine Treatment Optimization Questionnaire (mTOQ) and Migraine Disability Assessment (MIDAS) scale. Cognitive impairment was assessed using the Migraine Cognitive Impairment Questionnaire.
Of the 87.0% (12,612/14,492) of respondents with migraine who used medication for acute treatment, 23.5% (2965/12,612) used opioids (mean age 42.0 years; 62.7% female; mean BMI 27.1 kg/m2). Opioid users were more likely than nonusers to have severe disability overall (OR = 2.72 [95% CI: 2.1, 3.5]) and at each level of treatment optimization (very poor [64.7% vs 49.7%], poor [62.6% vs 46.5%], moderate [51.0% vs 35.6%], maximum [38.8% vs 19.9%]). Compared with those reporting maximum treatment optimization, the odds of moderate to severe disability increased as treatment optimization declined: moderate treatment optimization (OR=2.27 [95% CI: 2.0, 2.6]); poor (OR=3.51 [95% CI: 3.1, 4.0]); very poor (OR=3.85 [95% CI: 3.2, 4.6]). Opioid users had higher mean (SD) cognitive impairment scores than nonusers (63.3 [26.4] vs 53.8 [30.2], p<0.001).

Among CaMEO-I respondents with migraine, opioid users were more likely than opioid nonusers to have moderate or severe disability, indicating a need for treatment optimization.  These cross-sectional data do not allow us to determine if disability drives opioid prescribing and use or if opioids lead to worsening disability. Opioid use was associated with greater cognitive impairment.

Authors/Disclosures
Richard B. Lipton, MD, FAAN (Albert Einstein College of Medicine)
PRESENTER 		Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biohaven. Dr. Lipton has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GlaxoSmithKline. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vedanta. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Grifols. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axon. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Satsuma. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cool Tech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BDSI. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axsome. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Clexio. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shiratronics. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Lipton has stock in Biohaven. Dr. Lipton has stock in Manistee. Dr. Lipton has stock in Axon. Dr. Lipton has stock in CoolTech. The institution of Dr. Lipton has received research support from Teva. The institution of Dr. Lipton has received research support from Amgen. The institution of Dr. Lipton has received research support from Allergan/Abbvie. The institution of Dr. Lipton has received research support from Gammacore. The institution of Dr. Lipton has received research support from Axsome. The institution of Dr. Lipton has received research support from Charleston Labs. The institution of Dr. Lipton has received research support from Eli Lilly. The institution of Dr. Lipton has received research support from Satsuma. The institution of Dr. Lipton has received research support from NIH . The institution of Dr. Lipton has received research support from Veterans Administration. Dr. Lipton has received publishing royalties from a publication relating to health care.
Elizabeth Leroux, MD (Centre Medical Brunswick) Dr. Leroux has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. Dr. Leroux has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Teva Innovation Canada. Dr. Leroux has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lundbeck. Dr. Leroux has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Leroux has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie /Allergan. Dr. Leroux has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lin Pharmaceutical. Dr. Leroux has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Paladin. Dr. Leroux has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Teva. Dr. Leroux has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan. Dr. Leroux has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Allergan/Abbvie. Dr. Leroux has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Eli Lilly. Dr. Leroux has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Teva. Dr. Leroux has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Novartis. Dr. Leroux has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Lundbeck. Dr. Leroux has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Pfizer.
Dawn C. Buse, PhD (Dawn C. Buse, PhD) Dr. Buse has received personal compensation for serving as an employee of Vector Psychometric Group. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie-Allergan. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Theranicsa. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie-Allergan. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Buse has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Current Pain and Headache Reports. The institution of Dr. Buse has received research support from Amgen. The institution of Dr. Buse has received research support from FDA. The institution of Dr. Buse has received research support from National Headache Foundation.
Michel Lanteri-Minet, MD (CHU De Nice) Dr. Lanteri-Minet has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbvie. Dr. Lanteri-Minet has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. The institution of Dr. Lanteri-Minet has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eli Lilly. Dr. Lanteri-Minet has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lundbeck. Dr. Lanteri-Minet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. The institution of Dr. Lanteri-Minet has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Medtronic. Dr. Lanteri-Minet has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for TEVA. Dr. Lanteri-Minet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UPSA. Dr. Lanteri-Minet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for IPSEN. Dr. Lanteri-Minet has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Pfizer. The institution of Dr. Lanteri-Minet has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Pfizer. Dr. Lanteri-Minet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Savia BioElectronics. Dr. Lanteri-Minet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for ReckittBenckiser. The institution of Dr. Lanteri-Minet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Zambon. Dr. Lanteri-Minet has received publishing royalties from a publication relating to health care.
Fumihiko Sakai, MD Dr. Sakai has nothing to disclose.
Manjit Matharu (University College London) The institution of Manjit Matharu has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AbbVie. The institution of Manjit Matharu has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TEVA. The institution of Manjit Matharu has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AbbVie. The institution of Manjit Matharu has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Lundbeck. The institution of Manjit Matharu has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Pfizer. The institution of Manjit Matharu has received research support from Abbott. The institution of Manjit Matharu has received research support from EDS Society. The institution of Manjit Matharu has received research support from Medtronic. Manjit Matharu has received intellectual property interests from a discovery or technology relating to health care.
Zaza Katsarava, MD Zaza Katsarava, MD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Allergan. Zaza Katsarava, MD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. Zaza Katsarava, MD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Zaza Katsarava, MD has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TEVA. Zaza Katsarava, MD has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Lilly. Zaza Katsarava, MD has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Teva. Zaza Katsarava, MD has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis.
Janette Contreras-De Lama Janette Contreras-De Lama has received personal compensation for serving as an employee of AbbVie. Janette Contreras-De Lama has stock in AbbVie.
Nicole Naccara (Abbvie) Dr. Naccara has received personal compensation for serving as an employee of Abbvie . Dr. Naccara has stock in Abbvie.
Kristina M. Fanning, PhD (MIST Reserach) The institution of Dr. Fanning has received research support from Abbvie. The institution of Dr. Fanning has received research support from NYC Langone Health . The institution of Dr. Fanning has received research support from Uiversity of SC - Irvine. The institution of Dr. Fanning has received research support from AESARA.