Opioid therapy is associated with some degree of immunosuppression, but this is often poorly defined.
Mechanism: mu-opioid receptors in the CNS and lymphocytes
It may be suspected if there is an exacerbation of an underlying infection after starting opiate analgesia.
Factors impacting immune function:
(1) opioid or opiate being used (morphine, fentanyl)
(2) dose
(3) duration of therapy
(4) other medications impacting immune function (corticosteroids)
It may be significant in a patient with an existing degree of immunodeficiency or immunosuppression. For these patients a nonopioid analgesic may be preferrable.
The diagnosis requires exclusion of other conditions affecting immune function.
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