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The abuse of prescription drugs is an insidious complication among patients with chronic pain. This study examines cognitive intellectual functions in patients with chronic pain who are using prescribed analgesics, sedatives and hypnotics. A comprehensive battery of psychologic tests measuring intelligence, learning, memory, sensory-perceptual integrity, motor skills and general adaptive abilities was administered to 47 subjects. The subjects were patients admitted to a chronic pain management program, and they were divided into drug-dependent, drug-abusing and non-drug-abusing groups according to strictly defined criteria. Findings indicated that the prescribed use of these medications for pain over a prolonged time is detrimental to the cognitive function of such patients and complicates their clinical management.

Fifty patients with chronic pain and substance dependence were admitted to the hospital for treatment of substance dependence. Sixteen patients left treatment prematurely and were noted to have been less flexible in seeking treatment options for relief of pain. Most patients experienced an improved sense of well-being with abstinence, but this was not reflected in pain rating scales. At 1 and 3-4 years follow-up, the group that completed treatment was more outstanding in its commitment to a course of abstinence from drugs and alcohol than the group that had not completed treatment and seemed to experience a greater improvement in overall functioning.