What are the possible adverse effects of chronic opioid therapy (COT) for the treatment of sickle cell disease (SCD)?

Updated: May 12, 2021
  • Author: Joseph E Maakaron, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Adverse events that have been noted in other non-SCD patient populations are dose dependent and include increased risk of the following:

  • Poor surgical outcomes
  • Motor vehicle collisions
  • Myocardial infarction
  • Bone fracture
  • Mortality
  • Hormonal alterations, which can lead to sexual dysfunction, with doses of >120 mg morphine milligram equivalents (MME)
  • Overdose – Risk of overdose is ninefold higher with doses >100 mg MME, compared with doses < 20 mg MME in general non-SCD pain populations


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