scholarly journals Individuals with Chronic Pain Who Misuse Prescription Opioids Report Sex-Based Differences in Pain and Opioid Withdrawal

Pain Medicine ◽  
2019 ◽  
Vol 20 (10) ◽  
pp. 1942-1947 ◽  
Author(s):  
Andrew S Huhn ◽  
D Andrew Tompkins ◽  
Claudia M Campbell ◽  
Kelly E Dunn
Keyword(s):  
Chronic Pain ◽  
Pain Catastrophizing ◽  
Opioid Withdrawal ◽  
Self Report ◽  
Amazon Mechanical Turk ◽  
Opiate Withdrawal ◽  
Opioid Overdose ◽  
Prescription Opioids ◽  
Opioid Misuse ◽  
The Relationship

Abstract Objective Individuals with chronic pain who misuse prescription opioids are at high risk for developing opioid use disorder and/or succumbing to opioid overdose. The current study conducted a survey to evaluate sex-based differences in pain catastrophizing, opioid withdrawal, and current pain in persons with co-occurring chronic pain and opioid misuse. We hypothesized that women with chronic pain who misused prescription opioids would self-report higher pain ratings compared with men and that the relationship between pain catastrophizing and self-reported current pain would be moderated by symptoms of opioid withdrawal in women only. Design Survey assessment of the relationship between pain and opioid misuse. Setting Online via Amazon Mechanical Turk. Participants Persons with ongoing chronic pain who also misused prescription opioids on one or more days in the last 30 days were eligible (N = 181). Methods Participants completed demographic and standardized assessments including the Brief Pain Inventory (BPI), Pain Catastrophizing Scale (PCS), and Subjective Opiate Withdrawal Scale (SOWS). Results Women reported higher levels of current (P < 0.001), average (P < 0.001), and worst (P = .002) pain in the last 24 hours compared with men. Women also endorsed higher scores on the PCS (P = 0.006) and marginally higher past-30-day SOWS ratings (P = 0.068) compared with men. SOWS ratings moderated the relationship between PCS and BPI Worst Pain in women (ΔR2 < 0.127, ΔF(1, 78) = 12.39, P = 0.001), but not in men (ΔR2 < 0.000, ΔF(1, 98) = 0.003, P = 0.954). Conclusions These data suggest a strong relationship between opioid withdrawal, pain catastrophizing, and the experience of pain in women with chronic pain who misuse opioids.

scholarly journals Health(care) in the Crisis: Reflections in Science and Society on Opioid Addiction

2021 ◽  
Vol 18 (1) ◽  
pp. 341
Author(s):  
Roxana Damiescu ◽  
Mita Banerjee ◽  
David Y. W. Lee ◽  
Norbert W. Paul ◽  
Thomas Efferth
Keyword(s):  
Chronic Pain ◽  
Lived Experience ◽  
Narrative Analysis ◽  
Opioid Abuse ◽  
Societal Implications ◽  
Public Health Approach ◽  
Opioid Misuse ◽  
Post Surgery ◽  
Patient Narratives ◽  
The Relationship

Opioid abuse and misuse have led to an epidemic which is currently spreading worldwide. Since the number of opioid overdoses is still increasing, it is becoming obvious that current rather unsystematic approaches to tackle this health problem are not effective. This review suggests that fighting the opioid epidemic requires a structured public health approach. Therefore, it is important to consider not only scientific and biomedical perspectives, but societal implications and the lived experience of groups at risk as well. Hence, this review evaluates the risk factors associated with opioid overdoses and investigates the rates of chronic opioid misuse, particularly in the context of chronic pain as well as post-surgery treatments, as the entrance of opioids in people’s lives. Linking pharmaceutical biology to narrative analysis is essential to understand the modulations of the usual themes of addiction and abuse present in the opioid crisis. This paper shows that patient narratives can be an important resource in understanding the complexity of opioid abuse and addiction. In particular, the relationship between chronic pain and social inequality must be considered. The main goal of this review is to demonstrate how a deeper transdisciplinary-enriched understanding can lead to more precise strategies of prevention or treatment of opioid abuse.

scholarly journals The relationship between psychosocial factors and reported disability: The role of pain self-efficacy

2021 ◽  
Author(s):  
Antonio Varela
Keyword(s):  
Physical Activity ◽  
Chronic Pain ◽  
Low Back Pain ◽  
Psychosocial Factors ◽  
Self Efficacy ◽  
Pain Catastrophizing ◽  
Low Back ◽  
Mediating Role ◽  
The Relationship

Abstract Background Chronic pain in all its forms and the accompanying level of disability is a healthcare crisis that reaches epidemic proportions and is considered a world level crisis. Chronic non-specific low back pain contributes a significant proportion of chronic pain. Specific psychosocial factors and their influence on reported disability in a chronic non-specific low back pain (CNLBP) population was researched. Methods Psychosocial factors examined include fear, catastrophizing, depression, and pain self-efficacy. This cross-sectional correlational study examined the mediating role between pain self-efficacy and the specific psychosocial factors with reported disability. The study included 90 participants with CNLBP between 20 and 60 years of age. Participants completed the Fear Avoidance Belief Questionnaire, The Pain Catastrophizing Scale, The Patient Health Questionnaire-9, The Pain Self-Efficacy Questionnaire, and The Lumbar Oswestry Disability Index to measure fear of physical activity, pain catastrophizing, depression, pain self-efficacy, and reported disability, respectively. The study used multivariate regression and mediation analyses. Results The principal finding of the study was a strong inverse relationship between pain self-efficacy and reported disability. Further, pain self-efficacy was considered a statistic mediator for all psychosocial factors investigated within this data set. Pain self-efficacy was strongly considered to have a mediating role between reported fear of physical activity and disability, reported pain catastrophizing and disability, and reported depression and disability. Additionally, adjusting for age and reported pain levels proved to be statistically significant, and it did not alter the role of pain self-efficacy. Conclusion The results identified that pain self-efficacy had a mediating role in the relationship between the specific psychosocial factors of fear, catastrophizing, and depression and reported disability. Pain self-efficacy plays a more significant role in the relationships between specific psychosocial factors and reported disability with CNLBP than previously considered.

scholarly journals An Integrated Pain Team Model: Impact on Pain-Related Outcomes and Opioid Misuse in Patients with Chronic Pain

Pain Medicine ◽  
2020 ◽  
Vol 21 (9) ◽  
pp. 1977-1984
Author(s):  
Carolyn J Gibson ◽  
Joseph Grasso ◽  
Yongmei Li ◽  
Natalie Purcell ◽  
Jennifer Tighe ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Treatment Satisfaction ◽  
Subjective Experience ◽  
Pain Catastrophizing ◽  
Management Strategies ◽  
Health Administration ◽  
Opioid Misuse

Abstract Objective Biopsychosocial integrated pain team (IPT) care models are being implemented in Veterans Health Administration (VA) and other health care systems to address chronic pain and reduce risks related to long-term opioid therapy, with little evaluation of effectiveness to date. We examined whether IPT improves self-reported pain-related outcomes and opioid misuse. Design Single-group quality improvement study. Setting Large VA health care system. Subjects Veterans with chronic pain (N = 99, 84% male, mean age [SD] = 60 [13] years). Methods Using paired t tests and Wilcoxon matched-pairs signed-ranks tests, we examined pain experience (Brief Pain Inventory, Pain Catastrophizing Scale), opioid misuse (Current Opioid Misuse Measure), treatment satisfaction (Pain Treatment Satisfaction Scale), and pain management strategies among patients with chronic pain before and after three or more IPT encounters. Results After an average (SD) of 14.3 (9) weeks engaged in IPT, patients reported improvement in pain interference (mean [SD] = 46.0 [15.9] vs 40.5 [16.2], P &lt; 0.001), pain catastrophizing (mean [SD] = 22.9 [13.0] vs 19.3 [14.1], P = 0.01), treatment satisfaction (i.e., “very satisfied” = 13.1% at baseline vs 25.3% at follow-up, P = 0.01), and reduced opioid misuse (mean [SD] = 11.0 [7.5] vs 8.2 [6.1], P = 0.01). Patients reported increased use of integrative (i.e., acupuncture, 11% at baseline vs 26% at follow-up, P &lt; 0.01) and active pain management strategies (i.e., exercise, 8% at baseline vs 16% at follow-up, P &lt; 0.01) and were less likely to use only pharmacological pain management strategies after IPT engagement (19% at baseline vs 5% at follow-up, P &lt; 0.01). Conclusions Biopsychosocial, integrated pain care may improve patient-centered outcomes related to opioid misuse and the subjective experience and nonpharmacological self-management of chronic pain.

Gender-dependent difference in the relationship between pain aspects and pain catastrophizing

2019 ◽  
Vol 47 (2) ◽  
pp. 1-11 ◽  
Author(s):  
ChongNak Son ◽  
Daegu Son ◽  
Jeongwi An ◽  
Sungkun Cho
Keyword(s):  
Chronic Pain ◽  
Pain Catastrophizing ◽  
Republic Of Korea ◽  
Pain Clinic ◽  
Affective Pain ◽  
High Level ◽  
Gender Dependence ◽  
Study Participants ◽  
The Relationship

We examined the gender dependence of the relationships between sensory and affective pain and pain catastrophizing. Study participants were 170 people who were receiving treatment for chronic pain at a university pain clinic in Daegu, Republic of Korea. For men, higher levels of sensory pain were associated with greater pain catastrophizing at low and average levels of affective pain, but not at a high level of affective pain. For women, higher levels of affective pain were associated with greater pain catastrophizing, regardless of the degree of sensory pain. These results suggest that sensory pain, affective pain, and their combination may have gender-dependent effects on pain catastrophizing in people who are experiencing chronic pain. Most importantly, affective pain appears to play a major role in pain catastrophizing, regardless of gender and, for men, the role of sensory pain in pain catastrophizing requires consideration.

scholarly journals Perceived Injustice Moderates the Relationship between Pain and Depressive Symptoms among Individuals with Persistent Musculoskeletal Pain

2012 ◽  
Vol 17 (5) ◽  
pp. 335-340 ◽  
Author(s):  
Whitney Scott ◽  
Michael Sullivan
Keyword(s):  
Depressive Symptoms ◽  
Musculoskeletal Pain ◽  
Pain Catastrophizing ◽  
Self Report ◽  
Pain Severity ◽  
Hierarchical Regression ◽  
Perceived Injustice ◽  
Symptoms Of Depression ◽  
Post Hoc ◽  
The Relationship

BACKGROUND: Numerous investigations report that depressive symptoms frequently coexist with persistent pain. However, evidence suggests that symptoms of depression are not an inevitable consequence of pain. Diathesis-stress formulations suggest that psychological factors interact with the stress of pain to heighten the risk of depressive symptoms. Perceptions of injustice have recently emerged as a factor that may interact with the stress of pain to increase depressive symptoms.OBJECTIVES: The purpose of the present study was to examine whether perceived injustice moderates the relationship between pain and depressive symptoms.METHODS: A total of 107 individuals with persistent musculoskeletal pain completed self-report measures of pain severity, depressive symptoms, perceived injustice and catastrophizing.RESULTS: A hierarchical regression analysis revealed that the interaction between pain severity and perceived injustice uniquely contributed an additional 6% of the variance to the prediction of depressive symptoms, beyond the main effects of these variables. Post hoc probing indicated that pain was significantly related to depressive symptoms at high, but not low levels of perceived injustice. This finding remained statistically significant even when controlling for pain catastrophizing.CONCLUSIONS: The results suggest that perceived injustice augments the relationship between pain severity and depressive symptoms. The inclusion of techniques specifically targeting perceptions of injustice may enhance the effectiveness of interventions aimed at reducing symptoms of depression for individuals presenting with strong perceptions of injustice.

scholarly journals Pain Catastrophizing Moderates Relationships between Pain Intensity and Opioid Prescription

2017 ◽  
Vol 127 (1) ◽  
pp. 136-146 ◽  
Author(s):  
Yasamin Sharifzadeh ◽  
Ming-Chih Kao ◽  
John A. Sturgeon ◽  
Thomas J. Rico ◽  
Sean Mackey ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Pain Treatment ◽  
Pain Catastrophizing ◽  
Tertiary Care ◽  
Treatment Center ◽  
Women Patients ◽  
Opioid Prescription ◽  
Men And Women ◽  
The Relationship

Abstract Background Pain catastrophizing is a maladaptive response to pain that amplifies chronic pain intensity and distress. Few studies have examined how pain catastrophizing relates to opioid prescription in outpatients with chronic pain. Methods The authors conducted a retrospective observational study of the relationships between opioid prescription, pain intensity, and pain catastrophizing in 1,794 adults (1,129 women; 63%) presenting for new evaluation at a large tertiary care pain treatment center. Data were sourced primarily from an open-source, learning health system and pain registry and secondarily from manual review of electronic medical records. A binary opioid prescription variable (yes/no) constituted the dependent variable; independent variables were age, sex, pain intensity, pain catastrophizing, depression, and anxiety. Results Most patients were prescribed at least one opioid medication (57%; n = 1,020). A significant interaction and main effects of pain intensity and pain catastrophizing on opioid prescription were noted (P &lt; 0.04). Additive modeling revealed sex differences in the relationship between pain catastrophizing, pain intensity, and opioid prescription, such that opioid prescription became more common at lower levels of pain catastrophizing for women than for men. Conclusions Results supported the conclusion that pain catastrophizing and sex moderate the relationship between pain intensity and opioid prescription. Although men and women patients had similar Pain Catastrophizing Scale scores, historically “subthreshold” levels of pain catastrophizing were significantly associated with opioid prescription only for women patients. These findings suggest that pain intensity and catastrophizing contribute to different patterns of opioid prescription for men and women patients, highlighting a potential need for examination and intervention in future studies.

scholarly journals Time course of attentional bias to painful facial expressions and the moderating role of attentional control: an eye-tracking study

2019 ◽  
pp. 204946371986687 ◽  
Author(s):  
Mahdi Mazidi ◽  
Mohsen Dehghani ◽  
Louise Sharpe ◽  
Behrooz Dolatshahi ◽  
Seyran Ranjbar ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Attentional Bias ◽  
Facial Expressions ◽  
Attentional Control ◽  
Time Course ◽  
Pain Catastrophizing ◽  
Moderation Effect ◽  
Significant Difference ◽  
The Relationship ◽  
Pain Patients

Introduction: This study investigated the time course of attention to pain and examined the moderating effect of attentional control in the relationship between pain catastrophizing and attentional bias in chronic pain patients. Methods: A total of 28 patients with chronic pain and 29 pain-free individuals observed pictures of pain, happy and neutral facial expressions while their gaze behaviour was recorded. Pain intensity and duration, anxiety, depression, stress, attentional control and pain catastrophizing were assessed by questionnaires. Results: In all subjects, the pattern of attention for pain faces was characterized by initial vigilance, followed by avoidance. No significant difference was found between the two groups in terms of orientation towards the stimuli, the duration of first fixation, the average duration of fixation or number of fixations on the pain stimuli. Attentional control moderated the relationship between catastrophizing and overall dwell time for happy faces in pain patients, indicating that those with high attentional control and high catastrophizing focused more on happy faces, whereas the reverse was true for those with low attentional control. Conclusion: This study supported the vigilance–avoidance pattern of attention to painful facial expressions and a moderation effect of attentional control in the association between pain catastrophizing and attentional bias to happy faces among pain patients.

scholarly journals Pain catastrophizing, perceived injustice, and pain intensity impair life satisfaction through differential patterns of physical and psychological disruption

2017 ◽  
Vol 17 (1) ◽  
pp. 390-396 ◽  
Author(s):  
John A. Sturgeon ◽  
Maisa S. Ziadni ◽  
Zina Trost ◽  
Beth D. Darnall ◽  
Sean C. Mackey
Keyword(s):  
Chronic Pain ◽  
Life Satisfaction ◽  
Depressive Symptoms ◽  
Pain Intensity ◽  
Cognitive Appraisal ◽  
Pain Catastrophizing ◽  
Perceived Injustice ◽  
Appraisal Processes ◽  
The Relationship

AbstractBackground and purposePrevious research has highlighted the importance of cognitive appraisal processes in determining the nature and effectiveness of coping with chronic pain. Two of the key variables implicated in appraisal of pain are catastrophizing and perceived injustice, which exacerbate the severity of pain-related distress and increase the risk of long-term disability through maladaptive behavioural responses. However, to date, the influences of these phenomena have not been examined concurrently, nor have they been related specifically to quality of life measures, such as life satisfaction.MethodsUsing data froman online survey of330 individuals with chronic pain, structural path modelling techniques were used to examine the independent effects of pain catastrophizing, perceived injustice, and average pain intensity on life satisfaction. Two potential mediators of these relationships were examined: depressive symptoms and pain-related interference.ResultsResults indicated that depressive symptoms fully mediated the relationship between pain catastrophizing and life satisfaction, and pain interference fully mediated the relationship between pain intensity and life satisfaction. Both depressive symptoms and pain interference were found to significantly mediate the relationship between perceived injustice and life satisfaction, but perceived injustice continued to demonstrate a significant and negative relationship with life satisfaction, above and beyond the other study variables.ConclusionsThe current findings highlight the distinct affective and behavioural mediators of pain and maladaptive cognitive appraisal processes in chronic pain, and highlight their importance in both perceptions of pain-related interference and longer-term quality of life.

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