Opioid-Induced Adrenal Insufficiency: Causes, Symptoms, and What You Need to Know

When you take opioids long-term, your body can stop making enough opioid-induced adrenal insufficiency, a condition where chronic opioid use suppresses the adrenal glands’ ability to produce cortisol. It’s not a myth—it’s a documented side effect that shows up in up to 20% of people on high-dose or long-term opioid therapy. Most people never hear about it until they feel terrible after stopping their meds—or even while still taking them.

This isn’t just about withdrawal. adrenal insufficiency, a state where the adrenal glands don’t produce enough steroid hormones, especially cortisol. It’s a real medical condition that can cause fatigue, low blood pressure, nausea, and dizziness—symptoms often mistaken for depression, laziness, or opioid tolerance. The problem? Doctors rarely test for it. Cortisol levels drop because opioids mess with the HPA axis—the brain-to-adrenal signaling system that keeps your stress response working. No one tells you this when you’re prescribed painkillers for back pain, arthritis, or post-surgery recovery.

People on methadone, oxycodone, or morphine for months or years are most at risk. But even those on lower doses for a long time can develop it. And if you suddenly stop opioids without medical help, your body might not have enough cortisol to handle the stress—leading to adrenal crisis: vomiting, confusion, low blood pressure, even collapse. This isn’t just "feeling sick"—it’s life-threatening.

What You Should Do If You Suspect This

Don’t guess. If you’ve been on opioids for more than a few months and feel constantly tired, dizzy when you stand up, or get sick with minor infections, ask for a cortisol test. A simple blood draw in the morning can show if your levels are low. If they are, your doctor may need to adjust your opioid dose or give you a short course of replacement cortisol. You don’t have to quit opioids cold turkey to fix this—just get tested.

The posts below cover real cases, drug interactions, and medical guidance on managing opioid side effects. You’ll find guides on how to spot hidden hormonal problems, what to ask your doctor before starting or stopping opioids, and how other medications like antidepressants or pain relievers can make adrenal issues worse. These aren’t theoretical discussions—they’re from people who lived through it, and the doctors who helped them recover.

Martin Kelly 19 November 2025 12

Opioids and Adrenal Insufficiency: A Rare but Life-Threatening Side Effect You Need to Know

Opioid-induced adrenal insufficiency is a rare but life-threatening side effect of long-term opioid use. It suppresses stress hormones, mimics fatigue, and can cause fatal crashes during illness. Screening with an ACTH test can save lives.