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opioid abuse, mental illness

A new research study shows that patients who receive opioid drugs for chronic lower back pain get significantly less pain relief and are more likely to abuse the narcotic pain medications if they also suffer from some form of mental illness as well. According to University of Pittsburgh School of Medicine professor of anesthesiology and psychiatry and study author Ajay Wasan, M.D. “High levels of depression and anxiety are common in patients with chronic lower back pain. Learning that we are able to better predict treatment success or failure by identifying patients with these conditions is significant. This is particularly important for controlled substances such as opioids where, if not prescribed judiciously, patients are exposed to unnecessary risks and a real chance of harm, including addiction or serious side effects.”

The study on chronic back pain, opioid abuse, and mental illness involved 55 participants, and all of these individuals suffered from chronic back pain. Those who had high levels of anxiety or depression saw 50% less back pain relief and improvement, and this group also had 75% more opioid abuse. The group with symptoms of mental illness also saw increased side effects from the pain medications that were used. It is commonly recognized that mental illness, including anxiety and depression, can cause physical pain and other symptoms. Dr Wasan stated “It’s important for physicians to identify psychiatric disorders prior to deciding whether to prescribe opioids for chronic back pain as well as treat these conditions as part of a multimodal treatment plan. Rather than refusing to prescribe opioids, we suggest that these conditions be treated early and preferably before lower back pain becomes chronic. For those prescribed opioids, successful treatment of underlying psychiatric disorders may improve pain relief and reduce the chance of opioid abuse in these patients.”