• Robert N Jamison, Robert R Edwards, Roger Brown, Bruce P Barrett, Cindy A Burzinski, Robert P Lennon, Yoshio Nakamura, Tony Schiefelbein, Eric L Garland, and Aleksandra E Zgierska.
• Departments of Anesthesiology, Harvard Medical School, Brigham and Women's Hospital, Perioperative and Pain Medicine and Psychiatry, Chestnut Hill, MA.
• Clin J Pain. 2023 Dec 1; 39 (12): 643653643-653.

ObjectivesChronic pain is a significant health concern that adversely affects all aspects of life, including emotional well-being. Opioids are prescribed for the management of refractory, severe chronic pain, although they have been associated with adverse effects, including addiction and overdose. The aim of this study was to examine factors that predict thoughts of self-harm among adults with chronic pain who are prescribed opioids.Materials And MethodsSeven hundred sixty-five (N=765) persons with opioid-treated chronic lower back pain completed the Current Opioid Misuse Measure (COMM) and other validated questionnaires as part of a larger study. Response to 1 question from the COMM ("How often have you seriously thought about hurting yourself?") was used to assess suicide risk on a 5-point scale (0=never; 4=very often).ResultsParticipants were categorized into 3 groups according to their responses to the self-harm question: never (N=628; 82.1%), seldom or sometimes (N=74; 9.7%), and often or very often (N=63; 8.2%). Multivariate adjusted odds ratio (aOR) analyses indicated that reports of alcohol or drug overuse within the past month (aOR=1.41,[95% CI 1.11-1.78]), posttraumatic stress (PTSD; aOR=1.24,[1.07 to 1.44]), pain catastrophizing (aOR=1.03,[1.01 to 1.05]), not loving oneself (aOR=0.99,[.98-1.00]) and poor perceived mental health (aOR=0.94,[.92 to 97]) were most associated with thoughts of self-harm. Importantly, the ideation frequency of self-harm was highest among individuals treated with higher daily doses of opioids.DiscussionThese results support the need for continued monitoring of adults treated with opioids for chronic pain, particularly among those on high-dose opioids who present with increased negative affect and concerns of substance misuse.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

30 keywords...

hide…