Chronic Pain Among Patients With an Opioid Use Disorder.


Journal

The American journal on addictions
ISSN: 1521-0391
Titre abrégé: Am J Addict
Pays: England
ID NLM: 9208821

Informations de publication

Date de publication:
07 2021
Historique:
revised: 01 12 2020
received: 17 08 2020
accepted: 05 01 2021
pubmed: 20 3 2021
medline: 24 7 2021
entrez: 19 3 2021
Statut: ppublish

Résumé

Chronic pain is not well understood in opioid-dependent populations. We report the prevalence of chronic pain and pain characteristics in an opioid-dependent population by treatment type and gender. This cross-sectional study opportunistically recruited 569 patients (32% women) receiving treatment for opioid use disorder (DSM-5) in Norway during 2016-2018 (83% received opioid maintenance treatment, 17% received treatment without medication). We asked about chronic pain (≥3 months; ICD-11), pain severity (NRS-11), and other pain characteristics. Overall, 55% reported chronic pain (≥3 months), with a higher prevalence among women (61% vs 52%, P = .041) and patients receiving methadone (66%) compared with buprenorphine or no medication (46% and 45%, P < .001). Chronic pain was associated with higher age (P < .001) and higher doses of methadone (P = .048). The average duration of pain was 11 years. The most frequently reported pain locations were the lower extremities (59%) and the back (54%), and 69% reported more than one pain location. Constant pain and migrating pain were significantly associated with both moderate (adjusted odds ratio [aOR]: 2.04, confidence interval [CI]: 1.12-3.74 and aOR: 2.44, CI: 1.09-5.43) and severe pain intensity (aOR: 2.08, CI: 1.14-3.80 and aOR: 2.46, CI: 1.10-5.47). Reporting no effect of analgesics was associated with severe pain intensity (aOR: 0.54, CI: 0.29-0.99). Over half reported chronic pain, and rates were highest among women and patients receiving methadone. New contributions to the field are descriptions of pain characteristics by gender and pain severity, and interactions between medication type and age. (© 2021 The Authors. The American Journal on Addictions published by Wiley Periodicals LLC on behalf of The American Academy of Addiction Psychiatry). (Am J Addict 2021;00:00-00).

Sections du résumé

BACKGROUND AND OBJECTIVES
Chronic pain is not well understood in opioid-dependent populations. We report the prevalence of chronic pain and pain characteristics in an opioid-dependent population by treatment type and gender.
METHODS
This cross-sectional study opportunistically recruited 569 patients (32% women) receiving treatment for opioid use disorder (DSM-5) in Norway during 2016-2018 (83% received opioid maintenance treatment, 17% received treatment without medication). We asked about chronic pain (≥3 months; ICD-11), pain severity (NRS-11), and other pain characteristics.
RESULTS
Overall, 55% reported chronic pain (≥3 months), with a higher prevalence among women (61% vs 52%, P = .041) and patients receiving methadone (66%) compared with buprenorphine or no medication (46% and 45%, P < .001). Chronic pain was associated with higher age (P < .001) and higher doses of methadone (P = .048). The average duration of pain was 11 years. The most frequently reported pain locations were the lower extremities (59%) and the back (54%), and 69% reported more than one pain location. Constant pain and migrating pain were significantly associated with both moderate (adjusted odds ratio [aOR]: 2.04, confidence interval [CI]: 1.12-3.74 and aOR: 2.44, CI: 1.09-5.43) and severe pain intensity (aOR: 2.08, CI: 1.14-3.80 and aOR: 2.46, CI: 1.10-5.47). Reporting no effect of analgesics was associated with severe pain intensity (aOR: 0.54, CI: 0.29-0.99).
CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE
Over half reported chronic pain, and rates were highest among women and patients receiving methadone. New contributions to the field are descriptions of pain characteristics by gender and pain severity, and interactions between medication type and age. (© 2021 The Authors. The American Journal on Addictions published by Wiley Periodicals LLC on behalf of The American Academy of Addiction Psychiatry). (Am J Addict 2021;00:00-00).

Identifiants

pubmed: 33738870
doi: 10.1111/ajad.13153
doi:

Substances chimiques

Buprenorphine 40D3SCR4GZ
Methadone UC6VBE7V1Z

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

366-375

Informations de copyright

© 2021 The Authors. The American Journal on Addictions published by Wiley Periodicals LLC on behalf of The American Academy of Addiction Psychiatry (AAAP).

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Auteurs

Zill-E Huma Latif (ZH)

Department of Research and Development in Mental Health Service, Akershus University Hospital, Lørenskog, Norway.

Ingeborg Skjaervø (I)

Department of Research and Development in Mental Health Service, Akershus University Hospital, Lørenskog, Norway.
Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.

Kristin K Solli (KK)

Department of Research and Development in Mental Health Service, Akershus University Hospital, Lørenskog, Norway.
Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway.
Vestfold Hospital Trust, Tønsberg, Norway.

Lars Tanum (L)

Department of Research and Development in Mental Health Service, Akershus University Hospital, Lørenskog, Norway.
Faculty for Health Science, Oslo Metropolitan University, Oslo, Norway.

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