Management of Pain With Comorbid Substance Abuse

Krashin, Daniel; Murinova, Natalia; Ballantyne, Jane C.

doi:10.1007/s11920-012-0298-3

Cited by 23 publications

(29 citation statements)

References 51 publications

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“…While rates of addiction among those with chronic pain seem to be no different than those in the general population (Weaver and Schnoll, 2002), it also appears that chronic pain may be more prevalent in those with substance abuse history (Jamison et al, 2000; Rosenblum et al, 2003; Warner, 2012). The relationship between pain and addiction is remarkably complex, but most research has focused on clinical populations seeking treatment for pain (Cicero et al, 2008; Krashin et al, 2012; Sehgal et al, 2012). A more modest corpus of research has addressed the unique challenges introduced when treating chronic pain among patients receiving addiction treatment (for review see Pohl and Smith, 2012).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and experience of chronic pain in suburban drug injectors

Heimer

Zhan

Grau

2015

Drug and Alcohol Dependence

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Aims To explore the relationship between chronic pain and characteristics, behaviors, and psychological status of suburban Connecticut injection drug users. Methods Cross-sectional study with quantitative interview and serological testing for HIV and hepatitis B and C in 456 individuals who injected drugs in the past month were dichotomized into those reporting current chronic pain of at least six months duration and all others. The interview covered (i) sociodemographics, (ii) injection drug use, (iii) interactions with drug treatment, criminal justice, and harm reduction, (iv) screening for alcohol use, chronic pain, anxiety, and depression, and (v) knowledge regarding HIV, hepatitis B (HBV) and C (HCV), and opioid overdose. Serological testing for HIV, HBV, and HCV was conducted. Results One-third (n=143) reported chronic pain. These individuals differed significantly from those not reporting chronic pain on characteristics that included older age, lower educational achievement, and injection of pharmaceutical opioids. They also reported experiencing more psychological and family problems on the ASI and higher levels of depression and anxiety. Four of five individuals with chronic pain (117 of 148 providing chronology data) reported non-medical opioid use prior to the onset of chronic pain. Conclusions Chronic pain is common among drug injectors in our study population although it was unusual for chronic pain to have preceded non-medical opioid use. Psychological problems in injectors with co-occurring chronic pain are likely pose significant complications to successful treatment for substance abuse, pain, or infectious disease treatment.

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Section: Introductionmentioning

confidence: 99%

Prevalence and experience of chronic pain in suburban drug injectors

Heimer

Zhan

Grau

2015

Drug and Alcohol Dependence

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“…Literature searches were performed to identify SNPs that had been associated with pain in previous studies in PubMed, using the key words: pain, polymorphism, association, genetic, pharmacogenetic and other related words including substance abuse and psychiatric disorders that are known comorbidities [15,16]. A total of 115 SNPs from 49 genes were prioritized for this exploratory study, which is not an exclusive list of all pain-related SNPs.…”

Section: Methodsmentioning

confidence: 99%

Prevalence of Pain-Related Single Nucleotide Polymorphisms in Patients of African Origin with Sickle Cell Disease

et al. 2015

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Background Prospective pain genetics research is hindered by a lack of data on the prevalence of polymorphisms in pain-relevant genes for patients with sickle cell disease (SCD). For African–Americans in general, limited information is available in public databases. Methods We prioritized and examined the genotype and allele frequencies of 115 SNPs from 49 candidate pain genes in 199 adult African–Americans and pediatric patients of African origin with SCD. Analyses were performed and compared with available data from public databases. Results Genotype and allele frequencies of a number of SNPs were found to be different between our cohort and those from the databases and between adult and pediatric subjects. Conclusion As pain therapy is inadequate in a significant percentage of patients with SCD, candidate pain genetic studies may aid in designing precision pain medicine. We provide prevalence data as a reference for prospective genetic studies in this population.

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“…The high proportion of IDUs that self-manage their pain in this study may be due to inadequate pain management approaches for substance users in the clinical setting, as has been previously described in the literature [30,31]. Much of the focus of the literature on pain management among drug users is on practitioners’ experiences managing substance users’ pain in clinical settings [2,4,10,15].…”

Section: Discussionmentioning

confidence: 93%

Self-Management of Pain among People who Inject Drugs in Vancouver

et al. 2013

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SUMMARY Aims To evaluate factors and methods associated with self-management of pain among people who inject drugs (IDUs) in Vancouver (Canada). Patients & methods This cross-sectional study used bivariate statistics and multivariate logistic regression to analyze self-reported responses among 483 IDUs reporting moderate-to-extreme pain in two prospective cohort studies from 1 December 2012 to 31 May 2013. Results Median age was 49.6 years (interquartile range: 43.9–54.6 years), 33.1% of IDUs were female and 97.5% reported self-management of pain. Variables independently and positively associated with self-managed pain included having been refused a prescription for pain medication (adjusted odds ratio: 7.83; 95% CI: 1.64–37.3) and having ever been homeless (adjusted odds ratio: 3.70; 95% CI: 1.00–13.7). Common methods of self-management of pain included injecting heroin (52.7%) and obtaining diverted prescription pain medication from the street (65.0%). Conclusion Self-management of pain was common among IDUs who reported moderate-to-extreme pain in this setting, particularly among those who had been refused a prescription for pain medication and those who had ever been homeless. These data highlight the challenges of adequate pain management among IDUs.

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Management of Pain With Comorbid Substance Abuse

Cited by 23 publications

References 51 publications

Prevalence and experience of chronic pain in suburban drug injectors

Prevalence and experience of chronic pain in suburban drug injectors

Prevalence of Pain-Related Single Nucleotide Polymorphisms in Patients of African Origin with Sickle Cell Disease

Self-Management of Pain among People who Inject Drugs in Vancouver

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