Do pain patients at high risk for substance misuse experience more pain? A longitudinal outcomes study.
OBJECTIVE
The Screener and Opioid Assessment of Pain Patients (SOAPP v.1) has been shown to be a reliable measure of risk potential for substance misuse and to correlate with a history of substance abuse, legal problems, craving, smoking, and mood disorders among chronic pain patients. The aim of this study was to examine differences over time on a number of measures among chronic pain patients who were classified as high or low risk for opioid misuse based on scores on the SOAPP.


METHODS
From an initial sample of one hundred thirty-four participants (N = 134), one hundred and ten (N = 110) completed the SOAPP and were grouped as high or low risk for misuse of medication based on SOAPP scores of > or =7. All subjects were asked to complete baseline measures and in-clinic monthly diaries of their pain, mood, activity interference, medication, and side effects over a 10-month study period.


RESULTS
The results showed that although those who were classified as high-risk for opioid misuse reported significantly higher levels of pain intensity, activity interference, pain catastrophizing, disability, and depressed mood at baseline (P < 0.05), only pain intensity ratings were found to differentiate groups over time (P < 0.01). These results were unrelated to perceived helpfulness of pain treatment.


CONCLUSIONS
Differences in subjective pain intensity were found between those who are high risk for opioid misuse compared with those at low risk for medication misuse, implying that higher-risk patients may experience more subjective pain. Consequently, these patients may be more challenging to treat.
Jamison
Robert N
RN
Pain Management Center, Departments of Anesthesia and Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02467, USA. rjamison@partners.org
Link
Carol L
CL
Marceau
Lisa D
LD
D000328:Adult; D000368:Aged; D000375:Aging / Q000523:psychology; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use*; D002908:Chronic Disease; D003863:Depression / Q000150:complications / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008499:Medical Records; D001523:Mental Disorders / Q000150:complications / Q000523:psychology; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications / Q000523:psychology; D009483:Neuropsychological Tests; D010146:Pain / Q000188:drug therapy* / Q000523:psychology*; D010147:Pain Measurement; D019966:Substance-Related Disorders / Q000523:psychology*; D016896:Treatment Outcome
D000701:Analgesics, Opioid