Addiction: Pain self-medication “the norm” in substance-using primary care patients

human in pain

Abstract

BACKGROUND:

Chronic pain is common among patients with drug use disorders. The prevalence of chronic pain and its consequences in primary care patients who use drugs is unknown.

OBJECTIVES:

To examine: 1) the prevalence of chronic pain and pain-related dysfunction among primary care patients who screen positive for drug use, and 2) the prevalence of substance use to self-medicate chronic pain in this population.

DESIGN:

This was a cross-sectional analysis.

PARTICIPANTS:

This study included 589 adult patients who screened positive for any illicit drug use or prescription drug misuse, recruited from an urban, hospital-based primary care practice.

MAIN MEASURES:

Both pain and pain-related dysfunction were assessed by numeric rating scales, and grouped as: (0) none, (1-3) mild, (4-6) moderate, (7-10) severe. Questions were asked about the use of substances to treat pain.

CONCLUSIONS:

Chronic pain and pain-related dysfunction were the norm for primary care patients who screened positive for drug use, with nearly one-third reporting both severe pain and severe pain-related dysfunction. Many patients using illicit drugs, misusing prescription drugs and using alcohol reported doing so in order to self-medicate their pain. Pain needs to be addressed when patients are counseled about their substance use.

Alford DP, German JS, Samet JH, Cheng DM, Lloyd-Travaglini CA, Saitz RJ Gen Intern Med. 2016 Jan 25