Faculty Collaboration Database

Does opiate use in traumatically injured individuals worsen pain and psychological outcomes? J Pain 2013 Apr;14(4):424-30

Date

04/04/2013

Pubmed ID

23548492

DOI

10.1016/j.jpain.2012.12.016

Scopus ID

2-s2.0-84884468268 (requires institutional sign-in at Scopus site)   25 Citations

Abstract

UNLABELLED: 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.

Author List

Trevino CM, deRoon-Cassini T, Brasel K

Authors

Colleen Trevino PhD APP Clinical Dir Inpatient 2 in the Surgery department at Medical College of Wisconsin
Terri A. deRoon Cassini PhD Center Director, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Analgesics, Opioid
Anxiety
Chronic Pain
Comorbidity
Depression
Female
Humans
Male
Middle Aged
Wounds and Injuries