Public Release: 

Significant pain increases the risk of opioid addiction by 41 percent

First study to make direct link between pain and opioid addiction risk

Columbia University Medical Center

NEW YORK, NY (July 22, 2016) -- What do we really know about the relationship between the experience of pain and risk of developing opioid use disorder? Results from a recent study - the first to directly address this question -- show that people with moderate or more severe pain had a 41 percent higher risk of developing prescription opioid use disorders than those without, independent of other demographic and clinical factors.

These results, from researchers at Columbia University Medical Center, were published today in American Journal of Psychiatry.

The researchers analyzed data from a national survey of alcohol and substance use in more than 34,000 adults in two waves, three years apart. At each point, they examined pain (measured on a five-point scale of pain-related interference in daily activities), prescription opioid use disorders, and other variables such as age, gender, anxiety or mood disorders, and family history of drug, alcohol, and behavioral problems.

Participants who reported pain and those with prescription opioid use disorders were also more likely than others to report recent substance use, mood, or anxiety disorders or have a family history of alcohol use disorder.

"These findings indicate that adults who report moderate or more severe pain are at increased risk of becoming addicted to prescription opioids," said Mark Olfson, MD, MPH, professor of psychiatry at Columbia University Medical Center, and senior author of the report. "In light of the national opioid abuse epidemic, these new results underscore the importance of developing effective, multimodal approaches to managing common painful medical conditions."

Males and younger adults were at increased risk of prescription opioid use disorders, a finding that confirms results of previous studies. In addition, females and older adults were more likely to report pain.

"In evaluating patients who present with pain, physicians should also be attentive to addiction risk factors such as age, sex and personal or family history of drug abuse," Dr. Olfson added. "If opioids are prescribed, it is important for clinicians to monitor their patients carefully for warning signs of opioid addiction."

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The study, titled "Pain as a Predictor of Opioid Use Disorder in a Nationally Representative Sample," was published in the American Journal of Psychiatry on July 22, 2016. The authors are Carlos Blanco, Melanie M. Wall, Mayumi Okuda, Shuai Wang, Miren Iza, and Mark Olfson.

The authors report no financial relationships with commercial interests.

Work on this manuscript was supported by National Institute of Health grants MH076051, MH082773, and CA133050.

Columbia University Department of Psychiatry

Columbia Psychiatry holds the top ranking among the psychiatry departments in the nation and has contributed greatly to the understanding and treatment of brain disorders. Co-located at the New York State Psychiatric Institute on the NewYork-Presbyterian Hospital/Columbia University Medical Center campus in Washington Heights, the department enjoys a rich and productive collaborative relationship with physicians in various disciplines at Columbia University's College of Physician's and Surgeons. Columbia Psychiatry is home to distinguished clinicians and researchers noted for their clinical and research advances in the diagnosis and treatment of depression, suicide, schizophrenia, bipolar and anxiety disorders, eating disorders, substance use disorders, and childhood psychiatric disorders.

Columbia University Medical Center provides international leadership in basic, preclinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Columbia University Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest faculty medical practices in the Northeast. For more information, visit cumc.columbia.edu or columbiadoctors.org.

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