Chronic back pain sufferers with psychiatric disorders such as depression or anxiety are 75% more prone to opioid abuse according to a new study.
The study, published in Anesthesiology, the official medical journal of the American Society of Anesthesiologists (ASA), examined patients currently being treated for lower back pain with opioids. Researchers found that patients who suffered from psychiatric disorders such as depression or anxiety were significantly more likely to abuse their medication.In the study, researchers examined 55 chronic lower back patients who experienced low-to-high levels of depression or anxiety symptoms. Patients were given morphine, oxycodone or a placebo to take orally for the pain as needed over a 6-month period and recorded their pain levels and the doses taken daily.
Scientists discovered that patients suffering from high levels of depression or anxiety experienced increased side effects, 50% less improvement for back pain and 75% more opioid abuse when compared with patients with low levels who reported low levels of depression or anxiety.
A real chance of harm
Prof. Ajay Wasan, at the University of Pittsburgh School of Medicine, PA, stressed the importance of identifying patients beforehand who suffer from anxiety or depression. He said:
"This is particularly important for controlled substances such as opioids, where if not prescribed judiciously, patients are exposed to unnecessary risks and a real chance of harm, including addiction or serious side effects."
Prof. Wasan stressed the importance of physicians to treat chronic pain with opioids as part of a "multimodal plan." He also suggested that rather than physicians "refusing to prescribe opioids" they should ensure patients suffering from psychiatric disorders seek treatment for their condition as this may improve both pain relief and reduce the chance of opioid abuse.
Opioids work by binding to specific opioid receptors that located in the brain, spinal cord and gastrointestinal tract, blocking the brain's ability to perceive pain.
Enough for every American adult to have a bottle of pills
Chronic lower back pain currently affects an estimated 50 million adults in the US and can lead to the development of depression or anxiety. Last year, the Food and Drug Administration (FDA) approved a prescription opioid to combat the rising risk of substance abuse
According to the FDA, 46 people die from an overdose of prescription painkillers in the US everyday and in 2012, health care providers wrote 259 million prescriptions for painkillers, enough for every American adult to have a bottle of pills.
A study published in 2009 found that chronic back patients who suffered a history of depression were three times more likely to receive prescription for opioid medication compared with those who did not.