What do we really know about the relationship between the experience of pain and risk of developing opioid use disorder? Results from a recent study – the first to directly address this question—show that people with moderate or more severe pain had a 41 percent higher risk of developing prescription opioid use disorders than those without, independent of other demographic and clinical factors.

 

These results, from researchers at Columbia University Medical Center, were published today in American Journal of Psychiatry.

The researchers analyzed data from a national survey of alcohol and substance use in more than 34,000 adults in two waves, three years apart. At each point, they examined pain (measured on a five-point scale of pain-related interference in daily activities), prescription opioid use disorders, and other variables such as age, gender, anxiety or mood disorders, and family history of drug, alcohol, and behavioral problems.

Participants who reported pain and those with prescription opioid use disorders were also more likely than others to report recent substance use, mood, or anxiety disorders or have a family history of alcohol use disorder.

“These findings indicate that adults who report moderate or more severe pain are at increased risk of becoming addicted to prescription opioids,” said Mark Olfson, MD, MPH, professor of psychiatry at Columbia University Medical Center, and senior author of the report. “In light of the national opioid abuse epidemic, these new results underscore the importance of developing effective, multimodal approaches to managing common painful medical conditions.”

Males and younger adults were at increased risk of prescription opioid use disorders, a finding that confirms results of previous studies. In addition, females and older adults were more likely to report pain.

“In evaluating patients who present with pain, physicians should also be attentive to addiction risk factors such as age, sex and personal or family history of drug abuse,” Dr. Olfson added. “If opioids are prescribed, it is important for clinicians to monitor their patients carefully for warning signs of opioid addiction.”

The study, titled “Pain as a Predictor of Opioid Use Disorder in a Nationally Representative Sample,” was published in the American Journal of Psychiatry on July 22, 2016.