Chronic Pain Common Among Those Who OD on Opioids
TUESDAY, Nov. 28, 2017 -- More than 60 percent of opioid overdose deaths involve people who suffer from chronic pain, a new analysis reveals.
Many of them also struggled with depression or anxiety, the investigators found.
The findings stem from a study that examined the medical backgrounds of more than 13,000 men and women who died from an opioid overdose between 2001 and 2007.
"The frequent occurrence of treated chronic pain and mental health conditions among overdose decedents underscores the importance of offering substance use treatment services in clinics that treat patients with chronic pain and mental health problems," said lead investigator Dr. Mark Olfson, a professor of psychiatry at Columbia University Medical Center.
"Such a strategy," he said in a center news release, "might increase early clinical intervention in patients who are at high risk for fatal opioid overdose."
The number of Americans who died from an opioid overdose quadrupled from 1999 to 2015, according to data from the U.S. Centers for Disease Control and Prevention.
To explore the role that chronic pain plays in opioid abuse and deaths, the researchers focused on Medicaid enrollees who had died after an overdose. More than half of the 13,000 included in the analysis had been diagnosed with chronic pain in the year before they died. Roughly a third had been diagnosed with a drug use disorder in that year.
In addition, more than half had filled prescriptions for either opioids or benzodiazepines (sedatives or depressants), with many having sought out both drugs. Combining the two is very risky, as it can lead to a life-threatening case of extremely shallow breathing known as "respiratory depression," the researchers said.
Still, fewer than 1 in 20 of people included in the analysis had specifically been diagnosed as having had an opioid use disorder during their last month of life. This "suggests that dropout from drug treatment is common before fatal opioid overdose," Olfson said.
"Improving treatment retention, with contingency management or other effective behavioral interventions, might help lower the risk of fatal overdose in these patients," he said.
The current findings were published online Nov. 28 in the American Journal of Psychiatry.
Posted: November 2017