A population-based cohort study on chronic pain: the role of opioids.
OBJECTIVE
The aims of this study were 2-fold: (1) to investigate the consequences of opioid use in individuals with chronic pain in the Danish population, and (2) to investigate the development of and recovery from chronic pain from 2000 to 2005.


METHODS
Data derived from the Danish Health Interview Survey in 2000, which were linked on the individual level with register-based follow-up data. The survey was based on a county-stratified random sample of 16,684 individuals, out of which 10,434 individuals (62.5%) completed a face-to-face interview and returned a self-administered questionnaire. In addition, a subsample of the sample in 2000 was reinvited to a follow-up survey in 2005. In total, 3649 individuals (61.7%) of this subsample completed the interview and returned the questionnaire at baseline in 2000. At follow-up, 2354 of these participants completed the interview and returned the self-administered questionnaire. Respondents with cancer diagnosis were excluded from all analyses. Respondents with chronic pain were identified as having chronic/long-lasting pain more than 6 months.


CONCLUSIONS
The annual incidence for the development of and the recovery from chronic pain was 2.7% and 9.4%, respectively. Increasing age up to 64 years, short education, poor self-rated health, high body mass index, and physical strain at work were predictors of chronic pain. The odds of recovery from chronic pain were almost 4 times higher among individuals not using opioids compared with individuals using opioids. In addition, use of strong opioids was associated with poor health-related quality of life. Furthermore, the results indicated that individuals with chronic pain using strong opioids pain had a higher risk of death than individuals without chronic pain (HR: 1.67; 95% CI: 1.03-2.70). However, this study cannot exclude disease severity as the primary cause of increased mortality.
Sjøgren
Per
P
Section of Acute Pain Management and Palliative Medicine, Rigshospitalet, University of Southern Denmark, Copenhagen, Denmark. p.sjogren@mail.dk
Grønbæk
Morten
M
Peuckmann
Vera
V
Ekholm
Ola
O
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002908:Chronic Disease / Q000188:drug therapy / Q000453:epidemiology; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010146:Pain / Q000188:drug therapy* / Q000453:epidemiology*; D010147:Pain Measurement; D020127:Recovery of Function; D012042:Registries; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000701:Analgesics, Opioid