Journal
PAIN
Volume 162, Issue 8, Pages 2214-2224Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/j.pain.0000000000002220
Keywords
Chronic pain; Opioids; Hedonic effects; Calming effects; Opioid craving; Opioid misuse
Categories
Funding
- Canadian Institutes for Health Research (CIHR)
- International Association for the Study of Pain (IASP)
- Canadian Pain Society (CPS)
- Louise and Alan Edwards Foundation (LAEF)
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This study examined the impact of hedonic and calming effects of opioids on misuse among patients with chronic pain. The results indicated that these effects were associated with heightened opioid craving and were moderated by pain intensity, catastrophizing, and negative affect.
Concerns have been raised regarding the misuse of opioids among patients with chronic pain. Although a number of factors may contribute to opioid misuse, research has yet to examine if the hedonic and calming effects that can potentially accompany the use of opioids contribute to opioid misuse. The first objective of this study was to examine the degree to which the hedonic and calming effects of opioids contribute to opioid misuse in patients with chronic pain. We also examined whether the hedonic and calming effects of opioids contribute to patients' daily levels of opioid craving, and whether these associations were moderated by patients' daily levels of pain intensity, catastrophizing, negative affect, or positive affect. In this longitudinal diary study, patients (n = 103) prescribed opioid therapy completed daily diaries for 14 consecutive days. Diaries assessed a host of pain, psychological, and opioid-related variables. The hedonic and calming effects of opioids were not significantly associated with any type of opioid misuse behavior. However, greater hedonic and calming effects were associated with heightened reports of opioid craving (both P's < 0.005). Analyses revealed that these associations were moderated by patients' daily levels of pain intensity, catastrophizing, and negative affect (all P's < 0.001). Results from this study provide valuable new insights into our understanding of factors that may contribute to opioid craving among patients with chronic pain who are prescribed long-term opioid therapy. The implications of our findings for the management of patients with chronic pain are discussed.
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