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The Prevalence of Mental Health and Pain Symptoms in General Population Samples Reporting Nonmedical Use of Prescription Opioids: A Systematic Review and Meta-Analysis

  • Benedikt Fischer
    Correspondence
    Address reprint requests to Benedikt Fischer, PhD, Centre for Applied Research in Mental Health and Addiction (CARMHA), Faculty of Health Sciences, Simon Fraser University, 2400-515 W Hasting St, Vancouver, BC, V6B 5K3, Canada.
    Affiliations
    Centre for Applied Research in Mental Health and Addiction (CARMHA), Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada

    Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
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  • Anna Lusted
    Affiliations
    Centre for Applied Research in Mental Health and Addiction (CARMHA), Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
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  • Michael Roerecke
    Affiliations
    Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, Canada

    Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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  • Benjamin Taylor
    Affiliations
    Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, Canada

    Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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  • Jürgen Rehm
    Affiliations
    Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), Toronto, Canada

    Dalla Lana School of Public Health, University of Toronto, Toronto, Canada

    Department of Psychiatry, University of Toronto, Toronto, Canada

    Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
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Published:October 05, 2012DOI:https://doi.org/10.1016/j.jpain.2012.07.013

      Abstract

      Nonmedical prescription opioid use (NMPOU) has become a substantial public health concern in North America. Existing epidemiological data suggest an association between NMPOU and mental health or pain symptoms in different populations, although these correlations are not systematically assessed. To address this gap, a systematic search, review, and meta-analysis were completed separately for both mental health problem symptoms and pain in general population samples reporting NMPOU. Overall, 9 unique epidemiological studies were identified and included in the review. The pooled prevalence of any mental health symptoms in general population samples reporting NMPOU was 32% (95% confidence interval [CI]: 24–40). Specifically, the pooled prevalence of depression was 17% (95% CI: 14–19) and the prevalence of anxiety in general population samples of NMPOU was 16% (95% CI: 1–30) The pooled prevalence of pain in the population of interest was found to be 48% (95% CI: 37–59). This systematic review found evidence for disproportionately high prevalence levels of mental health problems and pain among general population samples reporting NMPOU. While the data reviewed cannot interpret dynamics of potential causality, these findings have implications for interventions for NMPOU, as well as medical practice involving prescription opioids.

      Perspective

      This systematic review and meta-analysis found evidence for disproportionately elevated rates of select mental health and pain problems in epidemiological studies based on general population samples reporting NMPOU. While causality cannot be established, these comorbidities may influence NMPOU behavior and hence ought to be considered in preventive and treatment interventions.

      Key words

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