Misuse of prescription opioids among chronic pain patients suffering from anxiety: A cross-sectional analysis

Feingold, Daniel; Brill, Silviu; Goor-Aryeh, Itay; Delayahu, Yael; Lev-Ran, Shaul

doi:10.1016/j.genhosppsych.2017.04.006

Cited by 24Opioid Use Disorder TreatmentPain Management and Opioid UseSubstance Abuse Treatment and Outcomes

Misuse of prescription opioids among chronic pain patients suffering from anxiety: A cross-sectional analysis

Feingold, Daniel, Brill, Silviu, Goor-Aryeh, Itay, Delayahu, Yael, Lev-Ran, Shaul·2017·General Hospital Psychiatry

DOI 10.1016/j.genhosppsych.2017.04.006

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Abstract

Objective In the past two decades, chronic pain has been increasingly treated with prescription opioids, particularly in developed countries. This has drawn public concern of possible risks associated with the potential misuse of prescriptions opioids. Previous research has indicated that this may be particularly true among individuals suffering from co-occurring psychiatric disorders. The present study sought to explore rates of misuse among chronic pain patients prescribed opioids, comparing individuals with and without anxiety.Methods Chronic pain patients receiving prescription opioids (N=554) were screened for anxiety using the Generalized Anxiety Disorder (GAD-7) scale and for opioid misuse using the Current Opioid Misuse Measure (COMM).Results Among patients who screened positive for anxiety (GAD-7≥10), 50% also screened positive for opioid misuse, compared to 10% among those without anxiety. After controlling for possible confounding sociodemographic and clinical variables, patients with anxiety were significantly more prone to screen positive for opioid misuse (Adjusted Odds Ratio (AOR)=2.18; 95% Confidence Interval (CI)=1.37-4.17) compared to those without anxiety. This was maintained when conducting separate comparisons for severe, but not mild or moderate, level of anxiety.Conclusions These findings highlight the importance of detecting and addressing co-occurring anxiety when treating patients with chronic pain who receive prescription opioids.

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Patients with high levels of anxiety and depression receiving opioid treatment for chronic pain are at increased risk of developing opioid misuse.
“Previous studies have consistently found that patients with high levels of anxiety and depression receiving opioid treatment for chronic pain are at increased risk of developing opioid misuse [80,81,82,83,84,85,86,87,88,89,90].”
From Pain acceptance creates an emotional context that protects against the misuse of prescription opioids: A study in a sample of patients with chronic noncancer pain (2021) · cites this paper as [87]

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Authors: Feingold, D., Brill, S., Goor-Aryeh, I., Delayahu, Y., & Lev-Ran, S.
Affiliations: Lev Hasharon Hospital (IL)
Tel Aviv Sourasky Medical Center (IL)
Tel Aviv University (IL)
Corresponding author: Feingold, Daniel
ORCID: Brill, Silviu
Delayahu, Yael
Venue: General Hospital Psychiatry
Publisher: Elsevier BV
Published: 2017-07
Volume: 47
Pages: 36-42
ISSN: 0163-8343 (ISSN-L)
DOI: 10.1016/j.genhosppsych.2017.04.006
OpenAlex: W2610516602
Cited by: 24
References: 62
Citations by year: 2026: 1 · 2025: 2 · 2024: 2 · 2022: 5 · 2021: 4 · 2020: 2 · 2019: 5 · 2018: 3
FWCI: 2.56
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: General Hospital Psychiatry (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords: prescription opioid misuse, chronic pain, anxiety, psychiatric comorbidity, opioid prescribing, generalized anxiety disorder, GAD-7, opioid misuse screening
MeSH terms: Adolescent, Adult, Aged, Analgesics, Opioid, Anxiety Disorders, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Comorbidity, Young Adult, Chronic Pain, Prescription Drug Misuse

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Misuse of prescription opioids among chronic pain patients suffering from anxiety: A cross-sectional analysis

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