Prevalence and experience of chronic pain in suburban drug injectors. (1st June 2015)

• Record Type: Journal Article
• Authors: Heimer, Robert; Zhan, Weihai; Grau, Lauretta E.
• Is Part Of: Drug and alcohol dependence. Volume 151(2015)
• Page Start: 92
• Page End: 100
• Publication Date: 2015-06-01
• Subjects: Injection drug use -- Chronic pain -- Suburbs -- Opioids -- Depression -- Anxiety; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2015.03.007
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Those with chronic pain were more likely to inject pharmaceutical opioids. Those with chronic pain had higher levels of depression and anxiety. In three-quarters of the cases, opioid abuse preceded the onset of chronic pain. Abstract: Aims: To explore the relationship between chronic pain and characteristics, behaviors, and psychological status of suburban Connecticut injection drug users. Methods: Cross-sectional study with quantitative interview and serological testing for HIV and hepatitis B and C in 456 individuals who injected drugs in the past month. Participants were dichotomized into those reporting current chronic pain of at least six months duration and all others. The interview covered (i) sociodemographics, (ii) injection drug use, (iii) interactions with drug treatment, criminal justice, and harm reduction, (iv) screening for alcohol use, chronic pain, anxiety, and depression, and (v) knowledge regarding HIV, hepatitis B (HBV) and C (HCV), and opioid overdose. Serological testing for HIV, HBV, and HCV was conducted. Results: One-third ( n = 143) reported chronic pain. These individuals differed significantly from those not reporting chronic pain on characteristics that included older age, lower educational achievement, and injection of pharmaceutical opioids. They also reported experiencing more psychological and family problems on the ASI and higher levels of depression and anxiety. Four of five individuals with chronic pain ( n = 117) reported non-medical opioid use prior to the onset of chronic pain. Conclusions: Chronic pain is common among drug injectors in our study population although it was unusual for chronic pain to have preceded non-medical opioid use. Psychological problems in injectors with co-occurring chronic pain are likely pose significant complications to successful treatment for substance abuse, pain, or infectious disease treatment.