The use of opioids is becoming a global epidemic, leading to a rise in the occurrence and recognition of the effects of opioid drugs on the endocrine system. Nonetheless, opioid-induced endocrinopathies still remain underdiagnosed, mainly because of symptom under-reporting by patients and poor clinician awareness. Hypogonadism is the most well recognised consequence of opioid use, but the inhibitory effects of opioid drugs on the hypothalamo-pituitary-adrenal axis and their negative effects on bone health also require attention. Hyperprolactinaemia might be detected in opioid users, but clinically relevant thyroid dysfunction has not been identified. The effects of opioids on other hormones have not been clearly defined. Assessment of gonadal and adrenal function (particularly if high index of clinical suspicion of hypogonadism or hypoadrenalism) and evaluation of bone health are advised in people that use opiods. Discontinuation or reduction of opioid dose and appropriate hormone replacement are the management approaches that should be considered for hypogonadism and hypoadrenalism. Further research is needed to facilitate the development of evidence-based guidelines on the diagnosis and optimal management of opioid-induced endocrinopathies.

中文翻译：

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阿片类药物引起的内分泌病变。

阿片类药物的使用正在成为一种全球流行病，导致阿片类药物对内分泌系统影响的发生和认识的增加。尽管如此，阿片类药物引起的内分泌病变仍未得到充分诊断，这主要是由于患者报告的症状不足和临床医生的意识较差。性腺功能减退是使用阿片类药物的最公认的结果，但阿片类药物对下丘脑-垂体-肾上腺轴的抑制作用及其对骨骼健康的负面影响也需要引起注意。阿片类药物使用者可能会发现高催乳素血症，但尚未发现临床相关的甲状腺功能障碍。阿片类药物对其他激素的作用尚未明确定义。建议使用阿片类药物的人评估性腺和肾上腺功能（特别是如果临床上怀疑性腺功能低下或肾上腺皮质功能低下的指标很高）和骨骼健康评估。停药或减少阿片类药物剂量和适当的激素替代是性腺功能减退和肾上腺皮质功能减退应考虑的治疗方法。需要进行进一步的研究以促进基于证据的指导原则的制定，以指导阿片类药物诱发的内分泌病变的诊断和最佳治疗。