Factors associated with chronic pain and non-medical opioid use among people who inject drugs

To study the prevalence and factors associated with opioid use in pain, 480 consecutive patients with a chief complaint of pain were interviewed at 10 clinics in Zahedan. The data were analysed in relation to 18 possible associated factors. The prevalence of opioid use was 28.5% in patients presenting with pain. There was no significant relation between opioid use and chronic pain [>/= 6 months], but there was a relationship with the following 5 factors:previous opioid use by friends [72.9% versus 20.4% without friends using], occupation [58.5% private sector employees/self-employed versus 17.4% housewives], cigarette smoking [60.8% versus 21.8% not smoking], consultation for a psychological problem [38.3% versus 23.3% without], and death of a spouse [60.0% versus 26.1% without]

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Opioid Use, Perioperative Risks, and Associated Postoperative Complications in Foot and Ankle Surgery

Foot & Ankle Specialist ◽

10.1177/1938640020977988 ◽

2020 ◽

pp. 193864002097798

Author(s):

Ryan Ridenour ◽

Christopher Kowalski ◽

Djibril Ba ◽

Guodong Liu ◽

Jesse Bible ◽

...

Keyword(s):

Mental Health ◽

Chronic Pain ◽

Postoperative Complications ◽

Tobacco Use ◽

Published Data ◽

Foot And Ankle ◽

Opioid Use ◽

Factors Associated ◽

National Crisis ◽

Ankle Surgery

Introduction Opioid abuse has become a national crisis. Published data demonstrate that patients undergoing foot and ankle surgery are left with excess narcotic medications postoperatively. The purpose of our study was to evaluate factors associated with prolonged postoperative opioid use following foot and ankle surgery and identify associations between preoperative opioid use and postoperative complications. Methods MarketScan commercial claims and encounters database was searched to identify foot and ankle patients. Preoperative comorbidities were queried and documented. Patients utilizing opioids 1 to 3 months prior to surgery were identified. Adjusted odds ratios and 95% CIs were calculated using multivariable logistic regression to determine associations between opioid use (preoperatively and postoperatively), readmission, and complications. Results A total of 112 893 patients were included in the study. Preoperative use had a statistically significant association with postoperative use out to 1 year. Tobacco use, chronic pain, mental health diagnosis, and nonopioid medications had a statistically significant association with postoperative use. Preoperative opioid use had a statistically significant association with readmission and postoperative complications. Conclusion Our study found a number of factors associated with prolonged postoperative opioid use (preoperative use, tobacco use, chronic pain, mental health disorders, and certain nonopioid medications). We identified an association between preoperative opioid use and postoperative complications and readmission. Levels of Evidence Prognostic Level IV Evidence

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A new OPIATE (Optimizing Positive Ibuprofen and Acetaminophen Treatment Expectations) model: A brief comment on “Concurrent and lagged associations of prescription opioid use with pain and negative affect in the daily lives of chronic pain patients” (Carpenter, Lane, Bruehl, & Trull, 2019).

Journal of Consulting and Clinical Psychology ◽

10.1037/ccp0000436 ◽

2019 ◽

Vol 87 (10) ◽

pp. 887-892

Author(s):

Jack Stevens ◽

Tarun Bhalla

Keyword(s):

Chronic Pain ◽

Negative Affect ◽

Prescription Opioid ◽

Opioid Use ◽

Treatment Expectations ◽

Daily Lives ◽

Chronic Pain Patients ◽

Prescription Opioid Use ◽

Pain Patients

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Faculty Opinions recommendation of Oral opioid use alters DNIC but not cold pain perception in patients with chronic pain - new perspective of opioid-induced hyperalgesia.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1119101.575248 ◽

2008 ◽

Author(s):

Robert Edwards ◽

Claudia Campbell

Keyword(s):

Chronic Pain ◽

Pain Perception ◽

Opioid Use ◽

Cold Pain ◽

Opioid Induced Hyperalgesia ◽

New Perspective

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Retrospective analysis on the effect of spinal cord stimulation on opioid consumption

Pain Management ◽

10.2217/pmt-2020-0016 ◽

2020 ◽

Author(s):

Awinita Barpujari ◽

Michael A Erdek

Keyword(s):

Spinal Cord ◽

Chronic Pain ◽

Retrospective Analysis ◽

Spinal Cord Stimulation ◽

Alternative Therapy ◽

Opioid Consumption ◽

Opioid Use ◽

Number Of Patients ◽

Chronic Pain Conditions ◽

Post Trial

Aim: Spinal cord stimulation (SCS) is used to clinically manage and/or treat several chronic pain etiologies. A limited amount is known about the influence on patients' use of opioid pain medication. This retrospective analysis evaluated SCS effect on opioid consumption in patients presenting with chronic pain conditions. Materials & methods: Sixty-seven patients underwent a temporary trial device, permanent implant or both. Patients were divided for assessment based on the nature of their procedure(s). Primary outcome was change in morphine equivalent dose (MED), ascertained from preoperative and postoperative medication reports. Results: Postoperative MED was significantly lower in patients who received some form of neuromodulation therapy. Pretrial patients reported an average MED of 41.01 ± 10.23 mg per day while post-trial patients reported an average of 13.30 ± 5.34 mg per day (p < 0.001). Pre-implant patients reported an average MED of 39.14 ± 13.52 mg per day while post-implant patients reported an average MED of 20.23 ± 9.01 mg per day (p < 0.001). There were no significant differences between pre-trial and pre-implant MED, nor between post-trial and post-implant MED. Of the 42 study subjects who reported some amount of pre-intervention opioid use, 78.57% indicated a lower MED (n = 33; p < 0.001), 16.67% indicated no change (n = 7) and 4.76% (n = 2) indicated a higher MED, following intervention. Moreover, SCS therapy resulted in a 26.83% reduction (p < 0.001) in the number of patients with MED >50 mg per day. Conclusion: Spinal cord stimulation may reduce opioid use when implemented appropriately. Neuromodulation may represent alternative therapy for alleviating chronic pain which may avoid a number of deleterious side effects commonly associated with opioid consumption.

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