Psychological Dependence and Prescription Opioid Misuse and Abuse

Abstract

There has been notable concern regarding the rising prevalence of prescription opioid misuse, abuse, and fatal overdoses. A great deal of scholarly activity has been devoted to identifying risk factors for opioid misuse/abuse and less effort on discovering modifiable factors to mitigate risk. In this issue of Pain Medicine , Elander and colleagues [1] conducted an online survey of 112 individuals in the general population who had pain and had used over-the-counter (OTC) and prescription analgesics in the last month. They assessed typical pain factors (frequency, intensity, pain type, and etiology), opioid abuse risk based on a validated risk assessment measure, the Screener and Opioid Assessment for Patients with Pain (SOAPP), mood and anxiety disorders, and frequency and use of OTC and prescription analgesics. In addition, they collected a number of psychological measures, some very novel (alexithymia, mindfulness, self-compassion), along with known possible pain and substance abuse mediators (pain catastrophizing, pain acceptance, pain self-efficacy). Statistical analysis of the relationship between analgesic dependence (based on a modified Leeds Dependence Questionnaire) and the measures of pain, mood, and aberrant drug-related behavior (ADRB) (SOAPP) and other psychological factors revealed that the best single predictor of analgesic dependence was the SOAPP. Other independent factors predictive of dependence were the frequency of analgesic use and the …