Abstract
Background: Chronic pain is a complex biopsychosocial phenomenon. Lifestyle, behavioral, socioeconomic, and psychosocial factors such as depression and perceived injustice are often associated with the development of chronic pain and vice versa. We sought to examine the interaction of these factors with opioid intake. Methods: At our institution, 164 patients with chronic pain undergoing an interdisciplinary assessment within a three-month period participated in the study and completed the Injustice Experience Questionnaire (IEQ). Data regarding opioid intake, pain levels, pain diagnosis, depression, anxiety, stress, quality of life, pain-related disability, habitual well-being, occupational status, and ongoing workers compensation litigation were extracted from the patients’ charts. Results: Approximately one-fourth of the patients used opioids. The IEQ total was significantly higher in patients using Schedule III opioids. Depression, but not the anxiety and stress scores, were significantly higher in patients using opioids. There were no significant differences regarding pain-related disability, habitual well-being, and the coded psychosocial diagnoses. In the patient group without opioids, the percentage of employed persons was significantly higher but there were no significant differences regarding work leave, pension application, or professional education. Conclusions: Opioid use appears to be more closely related to psychological factors and single social determinants of pain than to somatic factors.
Highlights
Chronic pain affects many aspects of daily activities, physical and mental health, family, social relationships, and workplace interactions [1]
Studies on opioid prescriptions show that besides compromised lifestyle factors such as physical activity and functioning, psychological and socioeconomic factors such as work force participation and social capital contribute to the amount of opioid consumption and the number of opioid-related deaths [1,6,7,8]
Consistent with previous research by Carriere et al [14] we found a significant correlation between opioid consumption and perceived injustice (IEQ total) in our study population
Summary
Chronic pain affects many aspects of daily activities, physical and mental health, family, social relationships, and workplace interactions [1]. The experience of recent years has shown that benefit and harm in treatment of non-cancer pain can be closely related, and that opioid consumption is influenced by different factors [3,4,5]. Numerous studies exist demonstrating that psychological comorbidities such as depression and anxiety are prevalent among patients with chronic non-cancer pain [3,6], and that these patients are more likely to receive long-term opioid therapy for pain [4]. Behavioral, socioeconomic, and psychosocial factors such as depression and perceived injustice are often associated with the development of chronic pain and vice versa. Depression, but not the anxiety and stress scores, were significantly higher in patients using opioids. In the patient group without opioids, the percentage of employed persons was significantly higher but there were no significant differences regarding work leave, pension application, or professional education
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