A recent study suggests that low amounts of caffeine consumption — measured by the number of cups of coffee consumed — reduces pain symptoms associated with fibromyalgia in patients who also take opioids.
Coffee consumption is associated with several health benefits, including increased vigilance, improved mood status, and positive cardiovascular effects.
Several studies have shown that caffeine, when administered in conjunction with analgesics such as aspirin or acetaminophen, can enhance the effects of these analgesics. However, the relationship between caffeine and chronic pain is still uncertain. Furthermore, caffeine’s role as an adjuvant for opioid use has not been studied.
Now, in the study “Caffeine as an opioid analgesic adjuvant in fibromyalgia,” researchers looked at how caffeine consumption affects pain symptoms in opioid-using and non-using fibromyalgia patients. The results were published in the Journal of Pain Research.
Patients with fibromyalgia were treated between 2010-2014 at the Back and Pain Center, Department of Anesthesiology, University of Michigan Health System. Each was asked to complete a survey. Patients self-reported their symptoms, coffee consumption (low, moderate, high), and opioid use. Participants were divided according to their caffeine consumption into three groups: Low was less than one cup a day, moderate use was 1.5–2.5 cups a day), and high consumption was classified as 3-12 cups a day.
Of the 962 fibromyalgia patients included in the study, 59 percent were on opioid therapy. There was no significant difference in coffee consumption between the opioid and non-opioid user groups, and the average age of both groups was 47 years old.
Among opioid users, caffeine consumption had modest but significant effects on pain, catastrophizing, and physical function. All caffeine dose groups showed lower pain catastrophizing and higher physical function, compared to those not taking caffeine.
Patients drinking low or moderate amounts of caffeine also had significantly less pain interference.
The moderate caffeine group also showed lower pain severity and depression.
There were no improvements associated with coffee consumption for non-opioid users, except for a higher physical function.
These results show that low or moderate levels of caffeine consumption can improve pain symptoms for patients with chronic pain who also have been prescribed opioids.
“Caffeine consumption was associated with decreased pain and symptom severity in opioid users, but not in opioid nonusers, indicating caffeine may act as an opioid adjuvant in fibromyalgia-like chronic pain patients.” the team wrote.
“These data suggest that caffeine consumption concomitant with opioid analgesics could provide therapeutic benefits not seen with opioids or caffeine alone.” the researchers concluded.