Chronic pain: comorbid depression tied to prescription opioid misuse

  • Feingold D & al.
  • J Affect Disord
  • 10 Apr 2018

  • curated by Deepa Koli
  • UK Clinical Digest
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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.

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