Chronic pain: comorbid depression tied to prescription opioid misuse

Takeaway

• Prescription opioid misuse is higher in patients with chronic pain and comorbid depression.
• Odds of prescription opioid misuse increased with depression severity.

Why this matters

• Chronic depression is an important contributor to opioid misuse; patients with chronic pain and comorbid depression are more likely to be prescribed opioids.
• This patient population should therefore be evaluated and monitored.

Study design

• 554 patients aged ≥18 years with chronic non-cancer pain received prescription opioids.
• Funding: Indivior Pharmaceuticals.

Key results

• 56.3% of patients were screened positive for depression.
• Rate of prescription opioid misuse was 29.1%.
• Patients with depression were at significantly higher risk for opioid misuse (aOR, 3.63; 95% CI, 1.71-7.7) vs those without depression.
• Risk for opioid misuse increased with increasing severity of depression:
  • Moderate depression: aOR, 3.71 (95% CI, 1.01-13.76).
  • Moderate-severe depression: aOR, 6.28 (95% CI, 1.6-24.57).
  • Severe depression: aOR, 14.66 (95% CI, 3.28-65.52).

Limitations

• Cross-sectional design.