To estimate the prevalence of opioid use in people with multiple sclerosis (PwMS).

Over 50% of PwMS report chronic pain that interferes with daily activities, employment, and quality of life. Opioids are not generally recommended for the management of chronic pain and opioid use has been declared a United States public health emergency. Little is known about the prevalence of opioid use in PwMS. The only published study on opioid use in PwMS found that 42% of PwMS with pain reported having ever used opioids and 38% reported currently using opioids.

Between 2013 and 2014, 282 PwMS reporting fatigue were screened to participate in a United States multisite MS fatigue management research study. Prescription and over the counter medication use was assessed by self-report questionnaires.

Fifty-eight of the 282 PwMS (21%) reported using prescription opioids, with some regional variation among study sites from a low of 14% in Baltimore and a high of 25% in Portland, Oregon. Forty-four of the 58 (76%) opioid users reported regular daily use, 10 (17%) reported using opioids as needed (PRN), three (5%) reported only short-term use (dental surgery, injury), and one (2%) provided incomplete information (no stop/start dates or dosages).

In this sample of PwMS self-reporting fatigue and interested in a MS fatigue management research study, more than one in five reported using prescription opioids and close to one in six used opioids daily.  This finding is consistent with 50% of PwMS having pain and the previous study finding that about 40% of PwMS with pain use opioids, supporting the validity of our estimate of the prevalence of opioid use in PwMS. This high level of opioid use supports that better pain management treatment options, including non-pharmacological options, are needed for PwMS and pain.