Highlights
- •Opioid and alcohol misuse was examined in opioid-using people with chronic pain.
- •The percentage of participants not misusing either substance was 35.9%.
- •The percentage of participants misusing both substances was 22.9%.
- •The percentage of participants misusing opioids was 38.2%.
- •The percentage of participants misusing alcohol was 3.1%.
- •No misuse was related to better functioning compared with misuse of opioids or both.
Abstract
Opioid misuse is regularly associated with disrupted functioning in those with chronic
pain. Less work has examined whether alcohol misuse may also interfere with functioning.
This study examined frequency of opioid and alcohol misuse in 131 individuals (61.1%
female) prescribed opioids for the treatment of chronic pain. Participants completed
an anonymous survey online, consisting of measures of pain, functioning, and opioid
and alcohol misuse. Cut scores were used to categorize individuals according to substance
misuse status. Individuals were categorized as follows: 35.9% (n = 47) were not misusing
either opioids or alcohol, 22.9% (n = 30) were misusing both opioids and alcohol,
38.2% (n = 50) were misusing opioids alone, and only 3.0% (n = 4) were misusing alcohol alone.
A multivariate analysis of variance was performed to examine differences in pain and
functioning between groups (after excluding individuals in the alcohol misuse group
due to the small sample size). Group comparisons indicated that individuals who were
not misusing either substance were less disabled and distressed in comparison to those
who were misusing opioids alone or both opioids and alcohol. No differences were indicated
between the latter 2 groups. Overall, the observed frequency of opioid misuse was
somewhat higher in comparison to previous work (approximately 1 out of every 3 participants),
and misuse of both alcohol and opioids was common (approximately 1 out of every 5
participants). While these data are preliminary, they do suggest that issues of substance
misuse in those with chronic pain extends beyond opioids alone.
Perspective
Opioid and alcohol misuse was examined in 131 individuals prescribed opioids for chronic
pain. In total, 35.9% were not misusing either, 22.9% were misusing both, 38.2% were
misusing opioids, and 3.1% were misusing alcohol. Individuals not misusing either
were generally less disabled and distressed compared to those misusing opioids or
both.
Key words
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Article info
Publication history
Published online: May 11, 2018
Accepted:
April 29,
2018
Received in revised form:
March 16,
2018
Received:
November 13,
2017
Footnotes
☆This research was supported by grants funded by the National Center for Complementary and Integrative Health for KEV (R34 AT08398, Vowles, principal investigator). The authors have no conflicts of interest to declare.
Identification
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© 2018 by the American Pain Society