What risk is associated with opioids when treating migraine headaches?

Opioids are often not the first-line treatment for migraine headaches due to the risk of developing rebound headaches, also known as overuse headaches. These occur when patients use acute treatment too frequently, leading to a cycle where the frequency and intensity of migraines can actually increase. Over time, reliance on opioids for pain relief can alter the normal headache pattern, resulting in more headaches and increased pain sensitivity. This phenomenon underscores why healthcare providers typically favor other medications, such as NSAIDs or triptans, for acute migraine treatment, reserving opioids for more severe cases or when other treatments are ineffective.

In contrast, while opioids can cause side effects like nausea, increased sensitivity to light (photophobia), and hypotension, these are not the primary concerns leading to the avoidance of opioids in migraine treatment. The long-term management of migraines focuses on preventive strategies to minimize headache frequency and severity, emphasizing the importance of avoiding the cycle of overuse associated with opioid medications.