Pain Journal: Opioids make patients with chronic pain feel better...and they like it...

[drusso]

Come at me, Bro...

Pain.

2021 Aug 1;162(8):2214-2224. doi: 10.1097/j.pain.0000000000002220.

Day-to-day hedonic and calming effects of opioids, opioid craving, and opioid misuse among patients with chronic pain prescribed long-term opioid therapy

Leah Frimerman 1, Maria Verner 2, Amanda Sirois 2, Katherine Scott 2, Alice Bruneau 1, Jordi Perez 3 4, Yoram Shir 3 4, Marc O Martel 2 3 4
Affiliations expand
PMID: 33729213 DOI: 10.1097/j.pain.0000000000002220

Abstract
Concerns have been raised regarding the misuse of opioids among patients with chronic pain. Although a number of factors may contribute to opioid misuse, research has yet to examine if the hedonic and calming effects that can potentially accompany the use of opioids contribute to opioid misuse. The first objective of this study was to examine the degree to which the hedonic and calming effects of opioids contribute to opioid misuse in patients with chronic pain. We also examined whether the hedonic and calming effects of opioids contribute to patients' daily levels of opioid craving, and whether these associations were moderated by patients' daily levels of pain intensity, catastrophizing, negative affect, or positive affect. In this longitudinal diary study, patients (n = 103) prescribed opioid therapy completed daily diaries for 14 consecutive days. Diaries assessed a host of pain, psychological, and opioid-related variables. The hedonic and calming effects of opioids were not significantly associated with any type of opioid misuse behavior. However, greater hedonic and calming effects were associated with heightened reports of opioid craving (both P's < 0.005). Analyses revealed that these associations were moderated by patients' daily levels of pain intensity, catastrophizing, and negative affect (all P's < 0.001). Results from this study provide valuable new insights into our understanding of factors that may contribute to opioid craving among patients with chronic pain who are prescribed long-term opioid therapy. The implications of our findings for the management of patients with chronic pain are discussed.

Copyright © 2021 International Association for the Study of Pain.

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[Ducttape]

congrats.

you've shown a study that opioids calm pain patients. that pleasant calming effect does not lead to opioid misuse, but the more psychological calming and hedonic effects there are, the more there is opioid craving, but not misuse.



but wait... previously someone established that there is no psychology in pain. it is all biologic/nerves/neurologic...



as far as the study - how many people are being prescribed chronic opioid medications are going to honestly report that they are misusing or abusing their drugs?

they used COMM as determinant of misuse, not UDS or pill counts or family interview...

 

[lobelsteve]

chemical coping.

 

[drusso]

congrats.

you've shown a study that opioids calm pain patients. that pleasant calming effect does not lead to opioid misuse, but the more psychological calming and hedonic effects there are, the more there is opioid craving, but not misuse.



but wait... previously someone established that there is no psychology in pain. it is all biologic/nerves/neurologic...



as far as the study - how many people are being prescribed chronic opioid medications are going to honestly report that they are misusing or abusing their drugs?

they used COMM as determinant of misuse, not UDS or pill counts or family interview...

Do you know what I say? I say, "F&ck'em." I don't give a rip if it helps your pain, makes you feel better, or you like it. We shouldn't overthink this: Put the leads at C2 or T8. If it's a VCF, go transpedicular or perpendicular. If there are Modic changes on T2, fry the bone. And if it hurts, fuse it.

 

[TheLoneWolf]

Said every spine surgeon

Do you know what I say? I say, "F&ck'em." I don't give a rip if it helps your pain, makes you feel better, or you like it. We shouldn't overthink this: Put the leads at C2 or T8. If it's a VCF, go transpedicular or perpendicular. If there are Modic changes on T2, fry the bone. And if it hurts, fuse it.

 

[Orin]

Thank god they're finally gathering data for the real indication for opioids: alleviating suffering.

 

[SeniorWrangler]

Hell, if they published this, maybe I can finally publish my manuscript, Bagels are Delicious, Especially with Lox and Cream Cheese
This represents thousands of man-hours of unpaid research on my part.

 

[Ducttape]

Not to ruin your research...

did you try grilling the bagel on a flat top with some ghee prior to the application of cream cheese??