Non-steroidal anti-inflammatory drugs and triptans are recommended first line treatments for acute migraine therapy. Opioids may produce increased sensitivity to pain and increase the risk that intermittent headache attacks will become more frequent and escalate to a chronic daily headache syndrome (medication overuse headache), particularly when opioids are used on 10 days a month or more. Opioids may impair alertness and produce dependence or addiction syndromes.
Sources:
Becker WJ. Acute Migraine Treatment in Adults. Headache. 2015 Jun;55(6):778-93. PMID: 25877672.
Toward Optimized Practice. Guideline for Primary Care Management of Headache in Adults [Internet]. 2016 Sep [cited 2017 Sep 19].
Worthington I, et al. Canadian Headache Society Guideline: acute drug therapy for migraine headache. Can J Neurol Sci. 2013 Sep;40(5 Suppl 3):S1-S80. PMID: 23968886.
Related Resources:
Patient Pamphlet: Treating Frequent Headaches with Pain Relievers: Don’t take them too often
Campaign: Opioid Wisely