Stimulant use for self-management of pain among safety-net patients with chronic non-cancer pain

被引:8
作者
Beliveau, Cathleen M. [1 ]
McMahan, Vanessa M. [1 ]
Arenander, Justine [1 ]
Angst, Martin S. [2 ]
Kushel, Margot [3 ]
Torres, Andrea [1 ]
Santos, Glenn-Milo [1 ,3 ]
Coffin, Phillip O. [1 ,3 ]
机构
[1] Ctr Subst Use & Hlth, San Francisco Dept Publ Hlth, San Francisco, CA USA
[2] Stanford Univ, Dept Perioperat & Pain Med, Sch Med, Stanford, CA USA
[3] Univ Calif San Francisco, San Francisco, CA 94143 USA
基金
美国国家卫生研究院;
关键词
Chronic pain; pain management; stimulants; methamphetamine; cocaine; safety-net clinic; METHAMPHETAMINE USE; TRANSGENDER WOMEN; SUBSTANCE USE; PREVALENCE; DISORDER; MORPHINE; COCAINE;
D O I
10.1080/08897077.2021.1903654
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
Background Chronic pain affects one-fifth of US adults. Reductions in opioid prescribing have been associated with increased non-prescription opioid use and, chronologically, increased stimulant (methamphetamine and cocaine) use. While non-prescription opioid use is commonly attributed to pain self-management, the role of stimulants in managing pain is unclear. Methods We analyzed baseline data from a longitudinal study of patients with chronic non-cancer pain in an urban safety-net healthcare system who had been prescribed an opioid for >= 3 of the last 12 months, and had a history of non-prescription opioid, cocaine, or amphetamine use (N = 300). We estimated the prevalence and identified correlates of stimulant use to treat pain among a subgroup of patients who reported past-year stimulant use (N = 105). Data sources included computer-assisted questionnaire (demographics, substance use, pain), clinical exam and procedures (pain, pain tolerance), and chart abstraction (opioid prescriptions). We conducted bivariate analyses to assess associations between demographics, pain characteristics, non-opioid therapies, substance use, opioid prescriptions, and self-reported symptoms, with reporting using stimulants to treat pain. Demographic variables and those with significant bivariate associations were included in a multivariable logistic regression model. Results Fifty-two percent of participants with past-year stimulant use reported using stimulants in the past year to treat pain. Participants who used stimulants for pain reported slightly higher average pain in the past 3 months (median of 8 (IQR: 6-8) vs 7 (7-9) out of 10, p = 0.049). In the multivariable analysis, female gender (AOR= 3.20, 95% CI: 1.06-9.63, p = 0.039) and higher score on the Douleur Neuropathique 4 neuropathic pain questionnaire (AOR = 1.34, 95% CI: 1.05-1.70, p = 0.017) were associated with past-year stimulant use to treat pain. Conclusion Stimulants may be used for pain self-management, particularly for neuropathic pain and among women. Our findings suggest an underexplored motivation for stimulant use in an era of reduced access to prescribed opioids.
引用
收藏
页码:179 / 186
页数:8
相关论文
共 45 条
[1]   Cocaine- and amphetamine-regulated transcript (CART): A multifaceted neuropeptide [J].
Ahmadian-Moghadam, Hamid ;
Sadat-Shirazi, Mitra-Sadat ;
Zarrindast, Mohammad-Reza .
PEPTIDES, 2018, 110 :56-77
[2]   Heroin and Methamphetamine Injection: An Emerging Drug Use Pattern [J].
Al-Tayyib, Alia ;
Koester, Stephen ;
Langegger, Sig ;
Raville, Lisa .
SUBSTANCE USE & MISUSE, 2017, 52 (08) :1051-1058
[3]  
[Anonymous], 2015, HIV infection, risk, prevention, and testing behaviors among persons who inject drugs-National HIV behavioral surveillance: Injection drug use, 20 U.S. cities
[4]   "Chasing the pain relief, not the high": Experiences managing pain after opioid reductions among patients with HIV and a history of substance use [J].
Behar, Emily ;
Bagnulo, Rita ;
Knight, Kelly ;
Santos, Glenn-Milo ;
Coffin, Phillip O. .
PLOS ONE, 2020, 15 (03)
[5]   Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4) [J].
Bouhassira, D ;
Attal, N ;
Alchaar, H ;
Boureau, F ;
Brochet, B ;
Bruxelle, J ;
Cunin, G ;
Fermanian, J ;
Ginies, P ;
Grun-Overdyking, A ;
Jafari-Schluep, H ;
Lantéri-Minet, M ;
Laurent, B ;
Mick, G ;
Serrie, A ;
Valade, D ;
Vicaut, E .
PAIN, 2005, 114 (1-2) :29-36
[6]   Prevalence of chronic pain with neuropathic characteristics in the general population [J].
Bouhassira, Didier ;
Lanteri-Minet, Michel ;
Attal, Nadine ;
Laurent, Bernard ;
Touboul, Chantal .
PAIN, 2008, 136 (03) :380-387
[7]   Life with jib: A snapshot of street youth's use of crystal methamphetamine [J].
Bungay, Vicky ;
Malchy, Leslie ;
Buxton, Jane A. ;
Johnson, Joy ;
Macpherson, Donald ;
Rosenfeld, Theo .
ADDICTION RESEARCH & THEORY, 2006, 14 (03) :235-251
[8]   The involvement of nicotinic receptor subtypes in the locomotor activity and analgesia induced by methamphetamine in mice [J].
Camarasa, Jorge ;
Garcia Rates, Sara ;
Pubill, David ;
Escubedo, Elena .
BEHAVIOURAL PHARMACOLOGY, 2009, 20 (07) :623-630
[9]  
Centers for Disease Control and Prevention, 2020, US OPIOID PRESCCRIBI
[10]  
Centers for Disease Control and Prevention, 2019, CALCULATING TOTAL DA