Psychological profiles and prescription opioid misuse, craving, and withdrawal in people with chronic pain

IF 3.5 2区医学 Q1 ANESTHESIOLOGY European Journal of Pain Pub Date : 2024-01-08 DOI:10.1002/ejp.2233

R. Esteve, V. Barrado-Moreno, C. Ramírez-Maestre, E. R. Serrano-Ibáñez, R. de la Vega, G. T. Ruiz-Párraga, G. Sainero-Tirado, M. Fernández Baena, M. Jensen, A. E. López-Martínez

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Abstract

Background

The negative consequences of prescription opioid misuse and opioid use disorder make it relevant to identify factors associated with this problem in individuals with chronic pain. This cross-sectional study aimed at identifying subgroups of people with chronic pain based on their psychological profiles, prescription opioid misuse, craving, and withdrawal.

Methods

The sample comprised 185 individuals with chronic pain. We performed hierarchical cluster analysis on impulsivity, anxiety sensitivity, pain acceptance, pain intensity, opioid misuse, craving, and withdrawal.

Results

The four-cluster solution was the optimal one. Misuse, craving, and anxiety sensitivity were higher among people in the Severe-problems cluster than among people in the other three clusters. Withdrawal was the highest in the High-withdrawal cluster. Impulsivity was higher among people in the Severe-problems and High-withdrawal clusters than those in the Moderate-problems and Mild-problems clusters. Pain acceptance was higher among people in the Mild-problems cluster than among people in the other three clusters. Anxiety sensitivity and misuse were higher among people in the Moderate-problems cluster than among people in the Mild-problems cluster.

Conclusions

These results support that impulsivity, anxiety sensitivity, and pain acceptance are useful constructs to identify subgroups of people with chronic pain according to their level of prescription opioid misuse, craving, and withdrawal. The results of this study may help in selecting the early intervention most suitable for each of the identified profiles.

Significance

The psychological profile of individuals with chronic pain, prescription opioid misuse, craving, and withdrawal is characterized by fearing anxiety-related symptoms due to the catastrophic interpretation of such symptoms and reacting impulsively to negative moods. In contrast, participants with high pain acceptance had less prescription opioid misuse, craving, and withdrawal. The profiles identified in this study could help clinicians select targets for intervention among profiles with similar needs and facilitate early interventions to prevent opioid misuse onset or aggravation.

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慢性疼痛患者的心理状况与处方阿片类药物滥用、渴求和戒断。

背景：处方阿片类药物滥用和阿片类药物使用障碍所带来的负面影响使得确定慢性疼痛患者中与这一问题相关的因素变得尤为重要。这项横断面研究旨在根据慢性疼痛患者的心理状况、处方阿片类药物滥用、渴求和戒断情况，确定慢性疼痛患者的亚群：样本包括 185 名慢性疼痛患者。我们对冲动性、焦虑敏感性、疼痛接受度、疼痛强度、阿片类药物滥用、渴望和戒断进行了分层聚类分析：结果：四聚类方案是最佳方案。严重问题群组中的滥用、渴望和焦虑敏感性高于其他三个群组。高度戒断群组的戒断率最高。严重问题群组和高度戒断群组中的人比中度问题群组和轻度问题群组中的人更容易冲动。轻度问题群组中对疼痛的接受程度高于其他三个群组。中度问题群组中焦虑敏感度和滥用程度高于轻度问题群组：这些结果证明，冲动性、焦虑敏感性和疼痛接受度是根据处方阿片类药物滥用、渴求和戒断程度识别慢性疼痛患者亚群的有用指标。本研究的结果可能有助于选择最适合每个已识别特征的早期干预措施：慢性疼痛、处方阿片类药物滥用、渴求和戒断患者的心理特征是，由于对焦虑相关症状的灾难性解读而害怕这些症状，并对负面情绪做出冲动反应。相比之下，疼痛接受度高的参与者滥用、渴求和戒断处方阿片类药物的情况较少。本研究确定的特征可以帮助临床医生从具有相似需求的特征中选择干预目标，并促进早期干预，防止阿片类药物滥用的发生或加重。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.