Prevalence of Pain Among Nonmedical Prescription Opioid Users in Substance Use Treatment Populations: Systematic Review and Meta-analyses

被引:0
作者
Lusted, Anna [1 ]
Roerecke, Michael [2 ,3 ]
Goldner, Elliot [1 ]
Rehm, Juergen [2 ,3 ,4 ,5 ]
Fischer, Benedikt [1 ,3 ,4 ]
机构
[1] Simon Fraser Univ, Fac Hlth Sci, CARMHA, Vancouver, BC V6B 5K3, Canada
[2] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada
[3] Ctr Addict & Mental Hlth, Toronto, ON, Canada
[4] Univ Toronto, Dept Psychiat, Toronto, ON, Canada
[5] Tech Univ Dresden, Inst Clin Psychol & Psychotherapy, D-01062 Dresden, Germany
基金
加拿大健康研究院;
关键词
Prescription opioids; nonmedical use; dependence; pain; comorbidity; substance use treatment; prevention; systematic review; meta-analyses; CHRONIC NONCANCER PAIN; UNITED-STATES; MENTAL-HEALTH; RANDOMIZED-TRIALS; TREATED PATIENTS; DRUG-DEPENDENCE; PRIMARY-CARE; ABUSE; THERAPY; MISUSE;
D O I
暂无
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background: Prescription opioid analgesics (POA) are widely used in the pharmacotherapeutic treatment of acute and chronic pain in North America, where nonmedical prescription opioid use (NMPOU) has become a substantial public health concern in recent years. Existing epidemiological data suggest an association between NMPOU and pain problem symptoms in different populations, including samples in substance use treatment, although the extent of these correlations has not been systematically assessed. Objective: To systematically review and meta-analyze the prevalence of pain symptoms or problems among populations reporting NMPOU in substance use treatment. Study Design: Systematic review and meta-analyses. Methods: A systematic review and meta-analyses were conducted for pain symptoms in substance use treatment samples reporting NMPOU within the last 30 days or at admission to treatment. Overall, 8 unique epidemiological studies were identified and included in the meta-analyses; in 7 of these samples POAs were the primary drug and/or POA dependence was reported. Results: The pooled prevalence of pain in all NMPOU samples in substance use treatment was 58% (95% confidence interval [CI]: 53%-64%). The pooled prevalence of pain in the studies with POAs as the primary drug and/or POA dependence was 60% (95% CI: 52%-67%), and the prevalence of pain with "any" POA abuse (n = 2 studies) was 50% (95% CI: 40%-60%). Limitations: A small number of studies were available and included in the review; these were restricted to cross-sectional datasets only. Statistical heterogeneity was found in the meta-analytical results. Conclusions: Pain symptoms are disproportionately elevated in substance use treatment samples reporting NMPOU. Effective measures to prevent and treat NMPOU are urgently needed, although a substantive extent of NMPOU observed in this specific context may relate directly or indirectly to the presence of pain, e. g., either as an expression of ineffective pain care or as a consequence of previous POA-based interventions. At the same time, effective ways to treat and address ongoing pain issues in NMPOU samples need to be implemented, which may require ongoing opioid-based pharmacotherapeutic care aimed at both pain and dependence.
引用
收藏
页码:E671 / E684
页数:14
相关论文
共 108 条
[31]   The Prevalence of Mental Health and Pain Symptoms in General Population Samples Reporting Nonmedical Use of Prescription Opioids: A Systematic Review and Meta-Analysis [J].
Fischer, Benedikt ;
Lusted, Anna ;
Roerecke, Michael ;
Taylor, Benjamin ;
Rehm, Juergen .
JOURNAL OF PAIN, 2012, 13 (11) :1029-1044
[32]  
Fischer B, 2012, PAIN PHYSICIAN, V15, pES191
[33]   What percentage of chronic nonmalignant pain patients exposed to chronic opioid analgesic therapy develop abuse/addiction and/or aberrant drug-related behaviors? A structured evidence-based review [J].
Fishbain, David A. ;
Cole, Brandly ;
Lewis, John ;
Rosomoff, Hubert L. ;
Rosomoff, R. Steele .
PAIN MEDICINE, 2008, 9 (04) :444-459
[34]   Physicians charged with opioid analgesic-prescribing offenses [J].
Goldenbaum, Donald M. ;
Christopher, Myra ;
Gallagher, Rollin M. ;
Fishman, Scott ;
Payne, Richard ;
Joranson, David ;
Edmondson, Drew ;
McKee, Judith ;
Thexton, Arthur .
PAIN MEDICINE, 2008, 9 (06) :737-747
[35]   Universal precautions in pain medicine: A rational approach to the treatment of chronic pain [J].
Gourlay, DL ;
Heit, HA ;
Almahrezi, A .
PAIN MEDICINE, 2005, 6 (02) :107-112
[36]   Depression and Prescription Opioid Misuse Among Chronic Opioid Therapy Recipients With No History of Substance Abuse [J].
Grattan, Alicia ;
Sullivan, Mark D. ;
Saunders, Kathleen W. ;
Campbell, Cynthia I. ;
Von Korff, Michael R. .
ANNALS OF FAMILY MEDICINE, 2012, 10 (04) :304-311
[37]   Disparities in pain: Ethical issues [J].
Green, Carmen ;
Todd, Knox H. ;
Lebovits, Allen ;
Francis, Michael .
PAIN MEDICINE, 2006, 7 (06) :530-533
[38]   Women who abuse prescription opioids: Findings from the Addiction Severity Index-Multimedia Version® Connect prescription opioid database [J].
Green, Traci C. ;
Serrano, Jill M. Grimes ;
Licari, Andrea ;
Budman, Simon H. ;
Butler, Stephen F. .
DRUG AND ALCOHOL DEPENDENCE, 2009, 103 (1-2) :65-73
[39]  
Greenland S, 2001, Biostatistics, V2, P463, DOI 10.1093/biostatistics/2.4.463
[40]   Office-based maintenance treatment of opioid dependence - How does it compare with traditional approaches? [J].
Gunderson, Erik W. ;
Fiellin, David A. .
CNS DRUGS, 2008, 22 (02) :99-111