Monday, July 25, 2016

Greater Pain Found to Increase Risk of Opioid Use Disorder

Researchers have long suspected that the level of pain experienced by a patient may increase his or her risk of developing an opioid use disorder. A study in AJP in Advance has for the first time taken a prospective look at this link, revealing a significant association between pain and prescription opioid use disorder at baseline and three years later.

Researchers at Columbia University and the National Institute on Drug Abuse analyzed data from a national sample of 34,653 adults who were surveyed three years apart. At each assessment, the participants were asked about their pain levels and prescription opioid use, as well as other substance use disorders, mood or anxiety disorders, and any family history of addiction or behavioral problems.

The researchers found that people with moderate or severe pain had a 41 percent higher risk of developing prescription opioid use disorders than those without, independent of demographics or other potential contributing factors. Males, younger adults (of either gender), and those with a family history of antisocial personality disorder were also found to be more likely to develop opioid use disorder.

There was no correlation for the inverse phenomenon; that is, people with an opioid disorder did not show any increased risk for developing chronic pain.

“Our findings highlight the need to provide evidence-based treatment for individuals in pain and to develop more effective nonopioid alternative treatments for those who do not respond to existing options,” the authors wrote. “From the clinical and preventive perspective, these clinical and demographic characteristics identify subgroups at increased risk who should be screened for pain and prescription opioid abuse.”

To read more about strategies to prevent opioid misuse, see the Psychiatric News column “Be Sure to Check the PDMP Before Prescribing Controlled Medications,” by Anna Lembke, M.D.

(Image: Paul Matthew Photography/Shutterstock)


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