Misuse of prescription opioids among chronic pain patients suffering from anxiety: A cross-sectional analysis

Abstract Objective In the past two decades, chronic pain has been increasingly treated with prescription opioids, particularly in developed countries. This has drawn public concern of possible risks associated with the potential misuse of prescriptions opioids. Previous research has indicated that t...

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Bibliographic Details
Published in:General hospital psychiatry 2017-07, Vol.47, p.36-42
Main Authors: Feingold, Daniel, Bril, Silviu, Goor-Aryeh, Itay, Delayahu, Yael, Lev-Ran, Shaul
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Analgesics, Opioid - therapeutic use
Anxiety
Anxiety Disorders - epidemiology
Chronic pain
Chronic Pain - drug therapy
Chronic Pain - epidemiology
Comorbidity
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Opioid misuse
Prescription Drug Misuse - statistics & numerical data
Prescription opioids
Psychiatry
Young Adult
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Summary:Abstract Objective In the past two decades, chronic pain has been increasingly treated with prescription opioids, particularly in developed countries. This has drawn public concern of possible risks associated with the potential misuse of prescriptions opioids. Previous research has indicated that this may be particularly true among individuals suffering from co-occurring psychiatric disorders. The present study sought to explore rates of misuse among chronic pain patients prescribed opioids, comparing individuals with and without anxiety. Methods Chronic pain patients receiving prescription opioids (N = 554) were screened for anxiety using the Generalized Anxiety Disorder (GAD-7) scale and for opioid misuse using the Current Opioid Misuse Measure (COMM). Results Among patients who screened positive for anxiety (GAD-7 ≥ 10), 50% also screened positive for opioid misuse, compared to 10% among those without anxiety. After controlling for possible confounding sociodemographic and clinical variables, patients with anxiety were significantly more prone to screen positive for opioid misuse (Adjusted Odds Ratio (AOR) = 2.18; 95% Confidence Interval (CI) = 1.37–4.17) compared to those without anxiety. This was maintained when conducting separate comparisons for severe, but not mild or moderate, level of anxiety. Conclusions These findings highlight the importance of detecting and addressing co-occurring anxiety when treating patients with chronic pain who receive prescription opioids.
ISSN:0163-8343
1873-7714
DOI:10.1016/j.genhosppsych.2017.04.006