Change of quality of life in patients with chronic pain with prescription opioid usage after opioid detoxification.

Abstract

Managing patients with chronic pain with long-term opioid therapy can be challenging for the prescribers, as the development of treatment complications such as addiction and opioid-induced hyperalgesia has to be considered. There is a paucity of information on the use of opioid detoxification protocols in patients with chronic pain on a long-term opioid therapy who have developed opioid-induced complications. To determine the effectiveness of detoxification treatment while presenting a different opioid detoxification protocol intended to cease patient's prescription opioid use while assessing patient's quality of life (QoL) changes, implicated by our treatment. We retrospectively studied 41 patients with chronic pain with long-term prescription opioid usage who underwent elective opioid detoxification in years 2010-2019 at the Toxicology Centre of Republican Vilnius University Hospital. We ceased prescription opioids during detoxification treatment and monitored withdrawal symptoms, pain intensity, and QoL by using SF-36 scores before and right after and a minimum of 3 months after detoxification. This study was fully completed by 14 patients. At the third SF-36 evaluation, 12 out of 14 patients (85.71 percent) reported the detoxification treatment as beneficial to their overall health status compared to that before the treatment, and SF-36 scores after detoxification were significantly higher than before the treatment (p = 0.001). A decreased pain level right after detoxification was indicated by 11 patients (78.6 percent). Significant pain decrease was observed both right after and at least 3 months after the opioid detoxification treatment (p < 0.05). As significant pain reduction, QoL life improvement, and opioid usage cessation were observed after opioid detoxification in the majority of patients with chronic pain, this leads us to believe that such a treatment can be safely administered and appropriated.