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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Article info
Publication history
Published online: October 05, 2012
Footnotes
The authors acknowledge research funding from the Canadian Institutes of Health Research (CIHR), specifically grants KRS-108448 and SAF-94814, supporting the implementation of this study. Dr. Fischer acknowledges a Michael Smith Foundation for Health Research (MSFHR) Senior Scholar Award, and a CIHR/PHAC Chair in Applied Public Health. Drs. B. Fischer and J. Rehm acknowledge funding support from the Ministry of Health and Long-Term Care of Ontario (MoHLTC).
The authors have no conflicts of interest to report.
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Copyright
© 2012 American Pain Society. Published by Elsevier Inc. All rights reserved.
