Anxiety sensitivity and pain intensity independently predict opioid misuse and dependence in chronic pain patients

• Published in: Psychiatry research 2020-12, Vol.294, p.113523, Article 113523
• Main Authors: Smit, Tanya, Rogers, Andrew H., Garey, Lorra, Allan, Nicholas P., Viana, Andres G., Zvolensky, Michael J.
• Format: Article
• Language: English
• Subjects: Adult; Analgesics, Opioid - adverse effects; Analgesics, Opioid - therapeutic use; Anxiety - diagnosis; Anxiety - epidemiology; Anxiety - psychology; Anxiety sensitivity; Chronic pain; Chronic Pain - drug therapy; Chronic Pain - epidemiology; Chronic Pain - psychology; Cross-Sectional Studies; Female; Humans; Male; Mass Screening - methods; Middle Aged; Opioid dependence; Opioid misuse; Opioid-Related Disorders - diagnosis; Opioid-Related Disorders - epidemiology; Opioid-Related Disorders - psychology; Pain Measurement - drug effects; Pain Measurement - methods; Pain Measurement - psychology; Predictive Value of Tests; United States - epidemiology
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2020.113523

•There is need to investigate opioid use among individuals with chronic pain.•We investigated anxiety sensitivity and pain intensity and opioid use outcomes.•Pain Intensity was significantly related to both opioid misuse and dependence.•Anxiety sensitivity was significant even after controlling for pain intensity. The United States (US) population consumes an estimated 68% of the world's prescribed opioids each year, and over 2 million adults in the US suffer from an opioid use disorder. Although chronic pain populations are among the highest risk segments of the general population for opioid misuse and dependence, there is little understanding of individual risk characteristics that may contribute to greater risk for these outcomes among this group. The present investigation explored the concurrent role of anxiety sensitivity and pain intensity and their interaction in relation to opioid misuse and dependence among 429 adults with chronic pain (73.9% female, Mage = 38.32 years, SD = 11.07). Results revealed that both anxiety sensitivity and pain intensity were associated with opioid misuse and dependence. There was no evidence of an interaction for either outcome. Post-hoc analyses indicated that of the lower-order anxiety sensitivity facets, physical and mental incapacitation concerns contributed to variance in opioid misuse and only mental incapacitation concerns contributed to variance in opioid dependence. Overall, the current findings suggest the importance of assessing anxiety sensitivity in screening for opioid-related problems among persons with chronic pain, as it may represent a distinct pathway to poorer opioid-related outcomes among this group.