Marc O Martel1, Patrick H Finan2, R Kathryn McHugh3, Mohammed Issa4, Robert R Edwards4, Robert N Jamison4, Ajay D Wasan5. 1. Department of Anesthesiology, Harvard Medical School, Brigham & Women's Hospital, Boston, MA, USA. Electronic address: momartel.bwh.harvard@outlook.com. 2. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 3. Division of Alcohol and Drug Abuse, Harvard Medical School, McLean Hospital, Belmont, MA, USA. 4. Department of Anesthesiology, Harvard Medical School, Brigham & Women's Hospital, Boston, MA, USA. 5. Departments of Anesthesiology and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
Abstract
BACKGROUND: Over the past decade, there has been a substantial rise in the use of opioids for the treatment of chronic noncancer pain. Despite the potential benefits of opioid therapy, the rise in the use of opioids has been accompanied by escalating rates of prescription opioid misuse and addiction. There is now a growing body of evidence indicating that opioid craving (i.e., the subjective desire to consume opioids) is one of the strongest determinants of opioid misuse among patients with chronic pain prescribed opioids. Although research has elucidated some of the factors associated with opioid craving, the contribution of patients' levels of pain to opioid craving remains unclear. OBJECTIVE: The main objective of this study was to examine the day-to-day association between pain and opioid craving. METHODS: In this longitudinal cohort study, patients with chronic pain prescribed opioid therapy completed baseline measures and were then asked to provide daily reports of pain intensity and opioid craving for a period of 14 days. RESULTS: Multilevel analyses indicated that day-to-day elevations in patients' levels of pain were associated with heightened opioid craving. That is, on more painful days, patients reported higher levels of craving. Within-person changes in pain intensity, however, explained less than 5% of the variance in patients' reports of craving. CONCLUSION: Findings from this study suggest that patients with chronic pain do not crave their opioid medications simply because they experience high levels of pain. The theoretical and clinical implications of our findings are discussed.
BACKGROUND: Over the past decade, there has been a substantial rise in the use of opioids for the treatment of chronic noncancer pain. Despite the potential benefits of opioid therapy, the rise in the use of opioids has been accompanied by escalating rates of prescription opioid misuse and addiction. There is now a growing body of evidence indicating that opioid craving (i.e., the subjective desire to consume opioids) is one of the strongest determinants of opioid misuse among patients with chronic pain prescribed opioids. Although research has elucidated some of the factors associated with opioid craving, the contribution of patients' levels of pain to opioid craving remains unclear. OBJECTIVE: The main objective of this study was to examine the day-to-day association between pain and opioid craving. METHODS: In this longitudinal cohort study, patients with chronic pain prescribed opioid therapy completed baseline measures and were then asked to provide daily reports of pain intensity and opioid craving for a period of 14 days. RESULTS: Multilevel analyses indicated that day-to-day elevations in patients' levels of pain were associated with heightened opioid craving. That is, on more painful days, patients reported higher levels of craving. Within-person changes in pain intensity, however, explained less than 5% of the variance in patients' reports of craving. CONCLUSION: Findings from this study suggest that patients with chronic pain do not crave their opioid medications simply because they experience high levels of pain. The theoretical and clinical implications of our findings are discussed.
Authors: Roger D Weiss; Margaret L Griffin; Carissa Mazurick; Benjamin Berkman; David R Gastfriend; Arlene Frank; Jacques P Barber; Jack Blaine; Ihsan Salloum; Karla Moras Journal: Am J Psychiatry Date: 2003-07 Impact factor: 18.112
Authors: Stephen F Butler; Kathrine Fernandez; Christine Benoit; Simon H Budman; Robert N Jamison Journal: J Pain Date: 2008-01-22 Impact factor: 5.820
Authors: Andrew Rosenblum; Herman Joseph; Chunki Fong; Steven Kipnis; Charles Cleland; Russell K Portenoy Journal: JAMA Date: 2003-05-14 Impact factor: 56.272
Authors: Eric L Garland; Eron G Manusov; Brett Froeliger; Amber Kelly; Jaclyn M Williams; Matthew O Howard Journal: J Consult Clin Psychol Date: 2014-02-03
Authors: Caroline A Arout; Andrew J Waters; R Ross MacLean; Peggy Compton; Mehmet Sofuoglu Journal: Psychopharmacology (Berl) Date: 2018-12-18 Impact factor: 4.530
Authors: Andrew H Rogers; Brooke Y Kauffman; Jafar Bakhshaie; R Kathryn McHugh; Joseph W Ditre; Michael J Zvolensky Journal: Am J Drug Alcohol Abuse Date: 2019-03-21 Impact factor: 3.829
Authors: John A Sturgeon; Jennifer M Hah; Yasamin Sharifzadeh; Stephanie K Middleton; Thomas Rico; Kevin A Johnson; Sean C Mackey Journal: Int J Behav Med Date: 2018-04
Authors: Judith I Tsui; Marlene C Lira; Debbie M Cheng; Michael R Winter; Daniel P Alford; Jane M Liebschutz; Robert R Edwards; Jeffrey H Samet Journal: Drug Alcohol Depend Date: 2016-06-27 Impact factor: 4.492
Authors: Lindsay M Lueptow; Elizabeth C Shashkova; Margaret G Miller; Christopher J Evans; Catherine M Cahill Journal: Curr Anesthesiol Rep Date: 2020-09-29
Authors: Chung Jung Mun; Patrick H Finan; David H Epstein; William J Kowalczyk; Daniel Agage; Janelle E Letzen; Karran A Phillips; Kenzie L Preston Journal: Addiction Date: 2020-12-29 Impact factor: 7.256
Authors: Anna Parisi; Hannah Louise Landicho; Justin Hudak; Siri Leknes; Brett Froeliger; Eric L Garland Journal: Drug Alcohol Depend Date: 2022-02-24 Impact factor: 4.852