Abstract
Opiate use for chronic pain is becoming increasingly controversial. There has been
a shift away from supporting the use of opiates for treatment of chronic pain. In
addition to lack of effectiveness, concerns for adverse clinical outcomes, addiction,
and death have provided the impetus for this change. The purpose of this study was
to investigate the percent of trauma patients still using opiates, their pain levels,
and psychological outcomes 4 months posttrauma. This was a study to evaluate chronic
pain at 4 months posttrauma in 101 participants from a single level 1 trauma center.
Eighty of the 101 participants developed chronic pain 4 months after their initial
traumatic injury (79%). Of those who developed chronic pain, 27 (26%) were still using
opiates. Those using narcotics at 4 months posttrauma had significantly more pain,
life interference, depression, and anxiety. Posttraumatic stress disorder (PTSD) was
not significantly influenced by narcotic use in this analysis. However, the mean associated
with those using narcotics was higher and diagnostic for PTSD. Those taking opiates
did not have significantly better relief from their pain using treatments or medications
than those not using opiates (F = 8, P = .08). These findings bring into question the appropriate use of opiates for chronic
pain and the possible exacerbating effects on pain and psychopathology in traumatically
injured patients.
Perspective
This article identifies data that provide evidence that narcotic pain medication needs
to be used carefully in traumatically injured patients with chronic pain, especially
in those individuals with comorbid psychological pathology.
Key words
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Article info
Publication history
Accepted:
December 26,
2012
Received in revised form:
December 8,
2012
Received:
October 16,
2012
Footnotes
No funding was obtained for this study.
There are no conflicts of interests associated with this study.
Identification
Copyright
© 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.
