title: Sexual Abuse and its Relation to Chronic Pain among Women from a Methadone Maintenance Clinic versus a Sexual Abuse Treatment Center.
abstract: To determine the effect of sexual abuse history on chronic pain and its relation to opioid addiction and methadone maintenance treatment (MMT), we studied current women MMT patients, and women patients from a sexual abuse treatment center with no history of opioid addiction. Questionnaires included Chronic Pain, Chronic Severe Pain, the Yale-Brown Obsessive Compulsive Scale, the Dissociative Experiences Scale (DES), and the Structured Interview for Disorders of Extreme Stress (complex-PTSD). Chronic severe pain was most prevalent among sexually abused women with no history of opioid addiction (64% of 25), followed by sexually abused MMT women (30.9% of 68), and MMT women with no history of sexual abuse (25% of 8, p = 0.01). Pain severity correlated with dissociation and complex-PTSD scores. The sexually abused non-MMT women had higher rates of high dissociation scores (DES ≥ 30) and complex-PTSD, but fewer obsessive-compulsive disorder symptoms (scored ≥16) than the MMT sexually abused women. Chronic pain was found to be highly prevalent among sexually abused women, independent of being methadone-maintained with an addiction history. The high known prevalence of chronic pain among MMT patients, which may be attributable to opioid-induced hyperalgesia, may partially reflect the sexual abuse history, and should be targeted in future studies evaluating pain indices.
authors.affiliation: a Research Director, Adelson Clinic for Drug Abuse Treatment & Research , Tel Aviv Sourasky Medical Center, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Einat
authors.initials: E
authors.lastname: Peles
authors.affiliation: b Clinic Director, Lotem Center for Sexual Abuse Treatment, Department of Psychiatry , Tel Aviv Sourasky Medical Center, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Zivya
authors.initials: Z
authors.lastname: Seligman
authors.affiliation: c Professor, Department of Psychiatry , Tel Aviv Sourasky Medical Center, Tel Aviv University , Tel Aviv , Israel.
authors.forename: Miki
authors.initials: M
authors.lastname: Bloch
authors.affiliation: d Criminologist, Adelson Clinic for Drug Abuse Treatment & Research, Tel Aviv Sourasky Medical Center , Tel Aviv University , Tel Aviv , Israel.
authors.forename: David
authors.initials: D
authors.lastname: Potik
authors.affiliation: e Research Assistant, Adelson Clinic for Drug Abuse Treatment & Research, Tel Aviv Sourasky Medical Center , Tel Aviv University , Tel Aviv , Israel.
authors.forename: Anat
authors.initials: A
authors.lastname: Sason
authors.affiliation: b Clinic Director, Lotem Center for Sexual Abuse Treatment, Department of Psychiatry , Tel Aviv Sourasky Medical Center, Tel Aviv University , Tel Aviv , Israel.|f Medical Director, Adelson Clinic for Drug Abuse Treatment & Research, Tel Aviv Sourasky Medical Center , Tel Aviv University , Tel Aviv , Israel.
authors.forename: Shaul
authors.initials: S
authors.lastname: Schreiber
authors.affiliation: g Clinic Chair Person, Adelson Clinic for Drug Abuse Treatment & Research, Tel Aviv Sourasky Medical Center , Tel Aviv University , Tel Aviv , Israel.
authors.forename: Miriam
authors.initials: M
authors.lastname: Adelson
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D059350:Chronic Pain / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008691:Methadone / Q000008:administration & dosage; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000379:methods; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012742:Sex Offenses / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D016320:Substance Abuse Treatment Centers; D011795:Surveys and Questionnaires
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone
keywords: Chronic pain; dissociation; methadone maintenance treatment; opiate addiction; sexual abuse