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Prolonged use of opioids may indeed mimic adrenocortical failure. Opioids used on a daily basis have been reported to affect the hypothalamic–pituitary–adrenal (HPA) axis at multiple levels 4,5 and opioid endocrinopathy has been documented as early as the 18th century. This phenomenon, is an under-recognised endocrinopathy with potentially life-threatening adverse effects and also blunts the cortisol response to corticotropin.4,6

Transient adrenal insufficiency secondary to chronic opioid drug therapy