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Healthcare 2016, 4(2), 34;

Differences in the Association between Depression and Opioid Misuse in Chronic Low Back Pain versus Chronic Pain at Other Locations

Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, USA
Department of Pharmacy Practice, School of Pharmacy, Southern Illinois University Edwardsville, Edwardsville, IL 62026, USA
Author to whom correspondence should be addressed.
Academic Editor: Robert J. Gatchel
Received: 8 March 2016 / Revised: 7 June 2016 / Accepted: 12 June 2016 / Published: 16 June 2016
(This article belongs to the Special Issue Low Back Pain: Recent Advances And Perspectives)
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Patients with chronic pain and depression are more likely to develop opioid abuse compared to patients without depression. It is not known if this association differs by pain location. We compared the strength of association between depression and opioid misuse in patients with chronic low back pain (CLBP) vs. chronic pain of other location (CPOL). Chart abstracted data was obtained from 166 patients seeking care in a family medicine clinic. Depression was measured by the PHQ-9 and opioid misuse was measured using the Current Opioid Misuse Measure. Pain severity and interference questions came from the Brief Pain Inventory. Cross-tabulations were computed to measure the association between depression and opioid misuse stratified on pain location. Exploratory logistic regression modeled the association between depression and opioid misuse after adjusting for pain location and pain severity and interference. Depression was significantly associated with opioid misuse in CPOL but not in CLBP. Regression results indicate pain interference partly accounts for the depression–opioid misuse association. These preliminary results from a small patient sample suggest depression may co-occur with opioid misuse more often in CPOL than in CLBP. Further research is needed to compare this comorbidity in specific pain diagnoses such as arthritis, fibromyalgia and CLBP. View Full-Text
Keywords: chronic pain; pain location; depression; opioid misuse chronic pain; pain location; depression; opioid misuse
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Jaiswal, A.; Scherrer, J.F.; Salas, J.; van den Berk-Clark, C.; Fernando, S.; Herndon, C.M. Differences in the Association between Depression and Opioid Misuse in Chronic Low Back Pain versus Chronic Pain at Other Locations. Healthcare 2016, 4, 34.

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