Cited by 15Adrenal Hormones and DisordersOpioid Use Disorder TreatmentNeuropeptides and Animal Physiology

The DOI matches its Crossref record; 251 of the 252 references it cites were found in a registry or an index, and 1 are not checked yet; 65 of the 244 sources its claims cite were checked for support.

Exogenous Opioids and the Human Endocrine System: An Endocrine Society Scientific Statement

Open access
Karavitaki, Niki, Bettinger, Jeffrey J, Biermasz, Nienke, Christ-Crain, Mirjam, Gadelha, Monica R, Inder, Warrick J, Tsourdi, Elena, Wakeman, Sarah E, Zatelli, Maria·2024·Endocrine Reviews

Abstract

The use and misuse of opioids are a growing global problem. Although the effects of these drugs on the human endocrine system have been studied for decades, attention on their related clinical consequences, particularly on the hypothalamic-pituitary system and bone health, has intensified over recent years. This Statement appraises research data related to the impact of opioids on the gonadal and adrenal function. Whereas hypogonadism is well recognized as a side effect of opioids, the significance of their inhibitory actions on the hypothalamic-pituitary-adrenal system and the occurrence of clinically relevant adrenal insufficiency is not fully elucidated. The often-inconsistent results of studies investigating how opioids affect the secretion of GH, prolactin, arginine vasopressin, and oxytocin are assessed. The accumulating evidence of opioid actions on bone metabolism and their negative sequelae on bone mineral density and risk of fracture are also reviewed. In each section, available data on diagnostic and management approaches for opioid endocrine sequelae are described. This Statement highlights a plethora of gaps in research associated with the effects and clinical consequences of opioids on the endocrine system. It is anticipated that addressing these gaps will improve the care of people using or misusing opioids worldwide. The Statement is not intended to serve as a guideline or dictate treatment decisions.

Verified 2026-10-11 · 1 reference not checked yet

Overview

Integrity signals

Registry

Crossref · 10.1210/endrev/bnae023

Cites

251 of 252 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

118 No full text of the sources · 43 Own interpretation · 27 Supported · 22 Partly supported · 15 No basis given · 6 Supported so far · 5 Not checked yet · 1 Mixed support · 1 Not supported · 1 Couldn’t confirm · accuracy not yet measured

Verify all 1 references — free account

Show all 141 claims

  • It may state two separate claims as one. 77
  • The quote only partly states this claim. 3
  • Probably not a substantial claim. 26
98 of 98
  • The paper relies on this without support.

    Opioid plasma concentration depends on drug dose, absorption, and metabolism.

    “In turn, the concentration depends on several factors, such as drug dose, absorption, and metabolism.”
1 of 1

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

1 of 1

Citations

Cites

Research works printed but not linked: 3

  1. Weiss, 2006, Healthcare Cost and Utilization Project (HCUP) Statistical Briefs
  2. Schumacher, 2021, Opioid Agonists & Antagonists. Basic & Clinical Pharmacology
  3. Bettinger, 2018, Fentanyl: separating fact from fiction, Pract Pain Manag, 18

Cited by

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Metadata

Authors
Karavitaki, N., Bettinger, J. J., Biermasz, N., Christ-Crain, M., Gadelha, M. R., Inder, W. J., Tsourdi, E., Wakeman, S. E., & Zatelli, M.
Affiliations
  • University Hospitals Birmingham NHS Foundation Trust (GB)
  • Saratoga Hospital (US)
  • Leiden University Medical Center (NL)
  • Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel , 4031 Basel ,
  • Endocrine Unit and Neuroendocrinology Research Center, Medical School and Hospital Universitário Clementino Fraga Filho—Universidade Federal do Rio de Janeiro (UFRJ) , Rio de Janeiro, 21941-913 ,
  • The University of Queensland (AU)
  • Technische Universität Dresden (DE)
  • Harvard University (US)
  • University of Ferrara (IT)
Venue
Endocrine Reviews
Published
2024-10-23
Volume
45
Issue
6
Pages
773-794
ISSN
  • 0163-769X (ISSN-L)
  • 1945-7189
OpenAlex
W4403713388
Cited by
14
References
252
Citations by year
2026: 6 · 2025: 8
FWCI
0.82
Type
journal article
Language
en
Open access
Locations
  • Endocrine Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • University of Birmingham Research Portal (University of Birmingham) (publishedVersion, other-oa)
Funders
  • Amgen
  • Eli Lilly and Company
  • Sanofi
  • Alexion Pharmaceuticals
  • Recordati Rare Diseases
  • Novo Nordisk
  • Ipsen
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuropeptides and Animal Physiology
Keywords
exogenous opioids, opioid misuse, hypothalamic-pituitary-adrenal axis, adrenal insufficiency, hypogonadism, gonadal function, growth hormone secretion, prolactin, vasopressin, oxytocin, bone metabolism, bone mineral density, fracture risk
MeSH terms
Analgesics, Opioid, Endocrine System, Endocrinology, Humans, Hypothalamo-Hypophyseal System, Pituitary-Adrenal System, Societies, Scientific, Bone Density

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