Exposure to Childhood Trauma Increases Risk of Opioid Use Disorder Among People Prescribed Opioids For Chronic Non-Cancer Pain

2021 ◽  
pp. 109199
Author(s):  
Thomas Santo ◽  
Gabrielle Campbell ◽  
Natasa Gisev ◽  
Louisa Degenhardt
Keyword(s):  
Cancer Pain ◽  
Childhood Trauma ◽  
Opioid Use Disorder ◽  
Opioid Use

Opioid use disorder and chronic pain: challenges for palliative care practice

2019 ◽  
Vol 25 (9) ◽  
pp. 453-457
Author(s):  
Brenda Peters-Watral
Keyword(s):  
Chronic Pain ◽  
Palliative Care ◽  
Substance Use ◽  
Pain Management ◽  
Cancer Pain ◽  
Opioid Use Disorder ◽  
Care Practice ◽  
Care Providers ◽  
Opioid Use ◽  
Multiple Cancer

Along with a well-documented increase in opioid use disorder (OUD) and a rapidly escalating rate of fatal overdose in North America, inadequate management of chronic pain remains a pervasive problem. The increasing number of individuals living with OUD also experience multiple cancer risk factors, which are related to their substance use, while people with cancer diagnoses have similar risks of current or past addiction as the general population. Recent pain guidelines focus on chronic non-cancer pain and do not include recommendations for cancer pain management. Managing cancer pain at the end of life is more challenging in people with current or past substance use disorder (SUD), especially OUD. Addressing these challenges requires confronting stigmas and stereotypes, building knowledge among palliative care providers and assessing the risks and benefits of opioids for pain management on an individual basis in order to continue to provide the holistic care.

scholarly journals Pluri Psychopathology and Risk of Opioid Use Disorder

2018 ◽  
Vol 3 (7) ◽  
Keyword(s):  
Risk Factors ◽  
Chronic Pain ◽  
Risk Factor ◽  
Cancer Pain ◽  
Gender Dysphoria ◽  
Psychiatric Comorbidity ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Transdermal Fentanyl ◽  
Case Presentation

Background: Psychiatric comorbidty is an important risk factor when predicting risk of opioid use disorder in chronic non-cancer pain. We present a case with gender dysphoria, in wich psychiatric comorbidity was not taken into account for de prescription of pharmacological treatment for pain. Case presentation: We report the case of a 51-year-old man with gender dysphoria, personality disorder, chronic pain disorder and opioid use disorder. For the last 9 years he has taken continuousy transdermal fentanyl prescribed by chronic non-cancer pain. Despite of presenting a pluripathology that discouraged the use of opioids in this patient, throughout his evolution, he has gone to different non-psychiatrists and has shown himself with a querulous, confictive and demanding attitude, so that he managed to keep on raising his dose of prescribed opioids. Conclusions: This case shows the importance of knowing the risk factors of consumption due to the use of opioids patients with chronic non-cancer pain, the importance of psychiatric comorbidity associated with prognosis and the neeed to know exactly how opioids are managed by some prescribers, as well as to carry out an interdisciplinary therapeutic plan to avoid risks.

scholarly journals Opioid Medication Use Among Chronic Non-Cancer Pain Patients Assessed with a Modified Drug Effects Questionnaire and the Association with Opioid Use Disorder

2020 ◽  
Vol Volume 13 ◽  
pp. 2697-2705
Author(s):  
Joseph A Boscarino ◽  
Carrie A Withey ◽  
Ryan J Dugan ◽  
Yirui Hu ◽  
Jessica Auciello ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Medication Use ◽  
Drug Effects ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Opioid Medication ◽  
Pain Patients

scholarly journals Analgesic Opioid Misuse and Opioid Use Disorder among Patients with Chronic Non-Cancer Pain and Prescribed Opioids in a Pain Centre in France

2021 ◽  
Vol 18 (4) ◽  
pp. 2097
Author(s):  
Morgane Guillou-Landreat ◽  
Bertrand Quinio ◽  
Jean Yves Le Reste ◽  
Delphine Le Goff ◽  
Jérôme Fonsecca ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Principal Component ◽  
Opioid Analgesics ◽  
Opioid Use Disorder ◽  
University Hospital ◽  
Opioid Misuse ◽  
Opioid Use ◽  
Cross Sectional ◽  
Pain Centre ◽  
A Current

(1) Background: Chronic non-cancer pain (CNCP) remains a public health challenge around the world. Opioids (PO) have been increasingly used in the treatment of CNCP in the last 20 years. This study aimed to assess the prevalence of opioid misuse and prescribed-opioid use disorder (p-OUD) among patients with CNCP in a pain centre in France, and to analyse risk factors for moderate or severe p-OUD. (2) Method: A cross-sectional study was conducted, including patients consulting for pain management in the pain centre of Brest University Hospital. A self-questionnaire was administered (sociodemographic data, medical data, PO misuse, and p-OUD according the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM 5) criteria). Descriptive, univariate, and multivariate analyses were conducted, together with a principal component analysis, in order to identify factors associated with p-OUD. (3) Results: In total, 115 patients were included, the majority of whom were women, with a mean age of 52 years old [18–82]; 64.3% (n = 74) had a current prescription for opioid analgesics (weak or strong). In this group, 56.7% (n = 42) had no or only mild p-OUD and 43.3% (n = 32) had current moderate or severe p-OUD. Patients with moderate or severe p-OUD were more likely to have a current antidepressant prescription, to have had psychotherapy, to currently use strong opioids and oxycodone, and to report taking more frequent doses than prescribed and feeling dependent. (4) Conclusions: We showed that the prevalence of current moderate/severe p-OUD concerned 43.3% of the patients with a CNCP seeking treatment in a pain centre. According to these results, several measures are relevant in managing p-OUD among patients with CNCP.

scholarly journals Beneficial Effects of Opioid Rotation to Buprenorphine/Naloxone on Opioid Misuse, Craving, Mental Health, and Pain Control in Chronic Non-Cancer Pain Patients with Opioid Use Disorder

2021 ◽  
Vol 10 (16) ◽  
pp. 3727
Author(s):  
Arnt F. A. Schellekens ◽  
Stijn E. Veldman ◽  
Eka S. D. Suranto ◽  
Steffie M. van Rijswijk ◽  
Selina E. I. van der Wal ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Large Scale ◽  
Psychiatric Symptoms ◽  
Opioid Use Disorder ◽  
Self Report ◽  
Inpatient Setting ◽  
Opioid Misuse ◽  
Opioid Use ◽  
Opioid Agonist ◽  
The Mean

Patients with chronic non-cancer pain (CNCP) often use opioids for long periods of time. This may lead to opioid use disorder (OUD) and psychiatric symptoms: mainly depression and anxiety. The current study investigated the effect of buprenorphine/naloxone (BuNa) rotation on opioid misuse, craving, psychiatric symptoms and pain in patients with CNCP and OUD. Forty-three participants with CNCP and OUD were converted from a full mu-receptor agonist opioid (mean morphine equivalent dose: 328.3 mg) to BuNa, in an inpatient setting. Opioid misuse, craving, co-occurring psychiatric symptoms, and pain perception were determined at baseline and after a two-month follow-up, using the following self-report questionnaires: Current Opioid Misuse Measurement (COMM), Visual Analog Scale (VAS-craving and VAS-pain) and Depression, Anxiety and Stress Scale (DASS), respectively. VAS-craving and VAS-pain were also determined immediately after conversion. A total of 37 participants completed the protocol. The mean COMM decreased from 17.1 to 6.7 (F = 36.5; p < 0.000), the mean VAS-craving decreased from 39.3 to 5.3 (−86.6%; F = 26.5, p < 0.000), the mean DASS decreased from 12.1 to 6.6 (F = 56.3, p < 0.000), and the mean VAS-pain decreased from 51.3 to 37.2 (−27.4%, F = 3.3; p = 0.043). Rotation to BuNa in patients with CNCP and OUD was accompanied by reductions in (i) opioid misuse, (ii) opioid craving, (iii) the severity of co-occurring psychiatric symptoms, and (iv) self-reported pain. BuNa as opioid agonist treatment may therefore be a beneficial strategy in CNCP patients with OUD. The limited sample size and the observational nature of this study underline the need for the replication of the current findings in large-scale, controlled studies.

scholarly journals Opioid Use Disorders among Patients on Long-Term Morphine for Management of Chronic Cancer Pain: A Pilot Study from a Tertiary Palliative Care Facility

2021 ◽  
Vol 27 ◽  
pp. 264-268
Author(s):  
Nandan Choudhary ◽  
Shalini Singh ◽  
Puneet Rathore ◽  
Atul Ambekar ◽  
Sushma Bhatnagar
Keyword(s):  
Cancer Pain ◽  
Cancer Patients ◽  
Opioid Analgesic ◽  
Care Facility ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Chronic Cancer Pain ◽  
Opioid Use Disorders ◽  
Pain Patients

Objectives: Long-term opioid use can be associated with misuse and addiction. In the backdrop of increasing burden of cancer patients in India, it is important to assess the rate of opioid use disorders among those with chronic cancer pain. The objectives were to measure the rate of opioid use disorder in chronic cancer pain patients being managed with morphine and to assess its association with demographic and clinical characteristics. Materials and Methods: A cross-sectional study was conducted on chronic cancer pain patients who were prescribed morphine for ≥12 months, dosage of ≥60 mg/day. They were assessed using MINI version 7.0.0, WHO-ASSIST Hindi questionnaire, Addiction Behavior Checklist, and DSM-5 for opioid use disorder. Results: Forty patients who were treated with morphine for a total of 1479 months participated. The average morphine consumption was 159.50 ± 327.90 mg/day. Six (15%) showed possible inappropriate opioid analgesic use and none of the patients had opioid use disorder. Conclusion: This study reports the absence of opioid use disorder due to vigilant use of morphine in chronic cancer patients.

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