title: Effects of opioid prescription medication dependence and detoxification on pain perceptions and self-reports.
abstract: The purpose of this work is to document whether prescription opioid medications used for pain enhanced or worsened pain syndromes from medical conditions in patients who received a diagnosis of prescription opioid dependence as determined by a diagnosis by Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria. Further, whether detoxification improved or worsened pain perceptions and self-reports in patients who chronically administered prescription opioid medications. Our study consisted of a retrospective sample of patients taken from the Addiction Treatment Unit at St Lawrence Hospital in Lansing, MI. Patients were selected from those who voluntarily sought detoxification from opioid medications in an inpatient setting. Selection criteria for the study consisted of a DSM-IV diagnosis of opioid prescription medication dependence, willingness to undergo medical detoxification, cooperation with self-report scales, and abstinence from opioid medications. Study patients were randomly selected from discharges in patient census for the years 2001 to 2003. The significant findings were that self-reported pain scores improved during the detoxification from admission to discharge, from a mean of 5.5 at admission to mean of 3.4 at discharge (0 is no pain and 10 is the most pain). The detoxification period extended to an average of 5 days. Whereas oxycodone CR (OxyContin) produced higher levels of self-reported pain at admission than at discharge, and these patients experienced significant levels of pain reduction with decremental opioid doses as with other opioid medications. Patients with a DSM-IV diagnosis of prescription opioid dependence reported (self) less pain with detoxification and abstinence from the opioid medications.
authors.affiliation: Department of Medicine, Michigan State University, East Lansing, MI, USA. norman.miller@ht.msu.edu
authors.forename: Norman S
authors.initials: NS
authors.lastname: Miller
authors.forename: Tom
authors.initials: T
authors.lastname: Swiney
authors.forename: Robert L
authors.initials: RL
authors.lastname: Barkin
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use; D003627:Data Interpretation, Statistical; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000523:psychology* / Q000534:rehabilitation*; D010146:Pain / Q000188:drug therapy; D010147:Pain Measurement / Q000187:drug effects*; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013375:Substance Withdrawal Syndrome / Q000523:psychology
chemical_list: D000701:Analgesics, Opioid