scholarly journals Risk for opioid misuse in chronic pain patients is associated with endogenous opioid system dysregulation

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Javier Ballester ◽  
Anne K. Baker ◽  
Ilkka K. Martikainen ◽  
Vincent Koppelmans ◽  
Jon-Kar Zubieta ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Low Risk ◽  
Opioid System ◽  
Opioid Misuse ◽  
Endogenous Opioid ◽  
Indirect Measure ◽  
Addictive Disorders ◽  
Functional Measures ◽  
Chronic Pain Patients ◽  
Pain Patients

Abstractµ-Opioid receptors (MOR) are a major target of endogenous and exogenous opioids, including opioid pain medications. The µ-opioid neurotransmitter system is heavily implicated in the pathophysiology of chronic pain and opioid use disorder and, as such, central measures of µ-opioid system functioning are increasingly being considered as putative biomarkers for risk to misuse opioids. To explore the relationship between MOR system function and risk for opioid misuse, 28 subjects with chronic nonspecific back pain completed a clinically validated measure of opioid misuse risk, the Pain Medication Questionnaire (PMQ), and were subsequently separated into high (PMQ > 21) and low (PMQ ≤ 21) opioid misuse risk groups. Chronic pain patients along with 15 control participants underwent two separate [11C]-carfentanil positron emission tomography scans to explore MOR functional measures: one at baseline and one during a sustained pain-stress challenge, with the difference between the two providing an indirect measure of stress-induced endogenous opioid release. We found that chronic pain participants at high risk for opioid misuse displayed higher baseline MOR availability within the right amygdala relative to those at low risk. By contrast, patients at low risk for opioid misuse showed less pain-induced activation of MOR-mediated, endogenous opioid neurotransmission in the nucleus accumbens. This study links human in vivo MOR system functional measures to the development of addictive disorders and provides novel evidence that MORs and µ-opioid system responsivity may underlie risk to misuse opioids among chronic pain patients.

Predicting Opioid Misuse by Chronic Pain Patients

2008 ◽  
Vol 24 (6) ◽  
pp. 497-508 ◽  
Author(s):  
Dennis C. Turk ◽  
Kimberly S. Swanson ◽  
Robert J. Gatchel
Keyword(s):  
Chronic Pain ◽  
Opioid Misuse ◽  
Chronic Pain Patients ◽  
Pain Patients

scholarly journals Translation, Cultural Adaptation and Validation of the Current Opioid Misuse Measure for European Portuguese

2020 ◽  
Vol 33 (4) ◽  
pp. 261
Author(s):  
Diogo Mendes-Morais ◽  
Cláudia Jantarada ◽  
Luís Guimarães-Pereira
Keyword(s):  
Chronic Pain ◽  
Principal Components ◽  
Cultural Adaptation ◽  
Good Practice ◽  
Opioid Misuse ◽  
Cronbach’S Alpha ◽  
Intra Class Correlation ◽  
Cronbach's Alpha ◽  
Chronic Pain Patients ◽  
Pain Patients

Introduction: Current practice guidelines recommend using Current Opioid Misuse Measure to screen aberrant opioid-related behaviors in chronic pain patients. Our aims were to translate, adapt and validate it to be used in Portuguese chronic pain patients.Material and Methods: Translation and cultural adaptation process followed guidelines and a model of principles for good practice. Adult chronic pain patients on opioid therapy, from one major hospital in Portugal, were invited to complete the translated version. Descriptive statistics, Cronbach’s alpha, inter-item, item-total and intra-class correlation coefficients and principal components analysis were applied.Results: Translation process was performed as planned and the validation sample was composed by 98 patients (median age = 62.5 years). Regarding internal consistency, a global Cronbach’s alpha of 0.778 was obtained and item-total correlations of all items were above 0.20 with four exceptions. An intra-class correlation coefficient of 0.90 was found between test and retest. Regarding validity, all 17 items presented a content validity index above 0.80. Six principal components were extracted and explained 66.3% of the variance.Discussion: The Portuguese version of Current Opioid Misuse Measure was properly translated, adapted and validated; showing good quality in terms of reliability and validity. This is the first instrument to screen aberrant opioid-related behaviors in Portuguese chronic pain patients. Consequently, it will aid and promote the identification of opioid misuse in these patients.Conclusion: The implementation of this questionnaire may reduce the incidence and morbimortality of opioid misuse among chronic pain patients and should improve chronic pain treatment in Portugal.

scholarly journals Cross Validation of the Current Opioid Misuse Measure to Monitor Chronic Pain Patients on Opioid Therapy

2010 ◽  
Vol 26 (9) ◽  
pp. 770-776 ◽  
Author(s):  
Stephen F. Butler ◽  
Simon H. Budman ◽  
Gilbert J. Fanciullo ◽  
Robert N. Jamison
Keyword(s):  
Chronic Pain ◽  
Cross Validation ◽  
Opioid Therapy ◽  
Opioid Misuse ◽  
Chronic Pain Patients ◽  
Pain Patients

(435) Reducing opioid misuse among chronic pain patients in primary care

2015 ◽  
Vol 16 (4) ◽  
pp. S84
Author(s):  
D. Jurcik ◽  
E. Ross ◽  
E. Scanlan ◽  
R. Jamison ◽  
M. Matthews
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Opioid Misuse ◽  
Chronic Pain Patients ◽  
Pain Patients

scholarly journals Cross-Validation of a Screener to Predict Opioid Misuse in Chronic Pain Patients (SOAPP-R)

2009 ◽  
Vol 3 (2) ◽  
pp. 66-73 ◽  
Author(s):  
Stephen F. Butler ◽  
Simon H. Budman ◽  
Kathrine C. Fernandez ◽  
Gilbert J. Fanciullo ◽  
Robert N. Jamison
Keyword(s):  
Chronic Pain ◽  
Cross Validation ◽  
Opioid Misuse ◽  
Chronic Pain Patients ◽  
Pain Patients

scholarly journals Behavioral preference for viewing drug v. pleasant images predicts current and future opioid misuse among chronic pain patients

2019 ◽  
Vol 50 (4) ◽  
pp. 644-652 ◽  
Author(s):  
Scott J. Moeller ◽  
Adam W. Hanley ◽  
Eric L. Garland
Keyword(s):  
Chronic Pain ◽  
Choice Behavior ◽  
Longitudinal Design ◽  
Choice Task ◽  
Prescription Opioid ◽  
Opioid Misuse ◽  
Chronic Pain Patients ◽  
Pain Patients ◽  
Insight Into

AbstractBackgroundThe USA is currently enduring an opioid crisis. Identifying cost-effective, easy-to-implement behavioral measures that predict treatment outcomes in opioid misusers is a crucial scientific, therapeutic, and epidemiological goal.MethodsThe current study used a mixed cross-sectional and longitudinal design to test whether a behavioral choice task, previously validated in stimulant users, was associated with increased opioid misuse severity at baseline, and whether it predicted change in opioid misuse severity at follow-up. At baseline, data from 100 prescription opioid-treated chronic pain patients were analyzed; at follow-up, data were analyzed in 34 of these participants who were non-misusers at baseline. During the choice task, participants chose under probabilistic contingencies whether to view opioid-related images in comparison with affectively pleasant, unpleasant, and neutral images. Following previous procedures, we also assessed insight into choice behavior, operationalized as whether (yes/no) participants correctly self-reported the image category they chose most often.ResultsAt baseline, the higher choice for viewing opioid images in direct comparison with pleasant images was associated with opioid misuse and impaired insight into choice behavior; the combination of these produced especially elevated opioid-related choice behavior. In longitudinal analyses of individuals who were initially non-misusers, higher baseline opioid v. pleasant choice behavior predicted more opioid misuse behaviors at follow-up.ConclusionsThese results indicate that greater relative allocation of behavior toward opioid stimuli and away from stimuli depicting natural reinforcement is associated with concurrent opioid misuse and portends vulnerability toward future misuse. The choice task may provide important medical information to guide opioid-prescribing practices.

scholarly journals Anhedonia in chronic pain and prescription opioid misuse

2019 ◽  
Vol 50 (12) ◽  
pp. 1977-1988 ◽  
Author(s):  
Eric L. Garland ◽  
Martin Trøstheim ◽  
Marie Eikemo ◽  
Gernot Ernst ◽  
Siri Leknes
Keyword(s):  
Chronic Pain ◽  
Large Scale ◽  
Reward Processing ◽  
Pain Severity ◽  
Prescription Opioid ◽  
Opioid Misuse ◽  
Opioid Use ◽  
Study Results ◽  
Chronic Pain Patients ◽  
Pain Patients

AbstractBackgroundBoth acute and chronic pain can disrupt reward processing. Moreover, prolonged prescription opioid use and depressed mood are common in chronic pain samples. Despite the prevalence of these risk factors for anhedonia, little is known about anhedonia in chronic pain populations.MethodsWe conducted a large-scale, systematic study of anhedonia in chronic pain, focusing on its relationship with opioid use/misuse, pain severity, and depression. Chronic pain patients across four distinct samples (N = 488) completed the Snaith–Hamilton Pleasure Scale (SHAPS), measures of opioid use, pain severity and depression, as well as the Current Opioid Misuse Measure (COMM). We used a meta-analytic approach to determine reference levels of anhedonia in healthy samples spanning a variety of countries and diverse age groups, extracting SHAPS scores from 58 published studies totaling 2664 psychiatrically healthy participants.ResultsCompared to healthy samples, chronic pain patients showed higher levels of anhedonia, with ~25% of patients scoring above the standard anhedonia cut-off. This difference was not primarily driven by depression levels, which explained less than 25% of variance in anhedonia scores. Neither opioid use duration, dose, nor pain severity alone was significantly associated with anhedonia. Yet, there was a clear effect of opioid misuse, with opioid misusers (COMM ⩾13) reporting greater anhedonia than non-misusers. Opioid misuse remained a significant predictor of anhedonia even after controlling for pain severity, depression and opioid dose.ConclusionsStudy results suggest that both chronic pain and opioid misuse contribute to anhedonia, which may, in turn, drive further pain and misuse.

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