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Chronic non-malignant pain (CNMP) and substance use disorders

Published online by Cambridge University Press:  23 March 2020

L. Herrera Duran ,
I. Falgas ,
B. Cook ,
N. Noyola ,
M. Toro  and
M. Alegria
L. Herrera Duran*
Affiliation:
Massachusetts General Hospital, Disparities Research Unit, Boston, USA
I. Falgas
Affiliation:
Vall d’hebrón University Hospital/Universitat Autonoma de Barcelona, Department of Psychiatry and Forensic Medicine, Barcelona, Spain
B. Cook
Affiliation:
Cambridge Health Alliance and Harvard Medical School, Health Equity Research Lab, Boston, USA
N. Noyola
Affiliation:
Massachusetts General Hospital, Disparities Research Unit, Boston, USA
M. Toro
Affiliation:
Massachusetts General Hospital, Disparities Research Unit, Boston, USA
M. Alegria
Affiliation:
Massachusetts General Hospital, Disparities Research Unit, Boston, USA
*
*Corresponding author.

Abstract

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Introduction

Chronic non-malignant pain (CNMP) is defined as pain lasting a minimum of three months. In general, chronic pain affects 20% adult worldwide population. Moreover, pain is more common in patients with depression, anxiety, and substance-use disorders and with low socioeconomic status. We aimed to better understand the influence of pain on substance use and treatment use patterns of individuals who experienced clinically recognized pain and have substance use disorder.

Methods

Patients with pain disturbances were identified in Electronic Health Records (EHR) through ICD-9 code 338*, medical written diagnoses, or diagnoses of fibromyalgia. A patient was considered to have a substance use disorder if he received treatment for illicit drug or alcohol abuse or dependence. We combined 2010–2012 (EHR) data from primary care and specialty mental health setting in a Boston healthcare system (n = 131,966 person-years) and a specialty mental health care setting in Madrid, Spain (n = 43,309 person-years).

Results

We identified that 35.3% of individuals with clinically recognized pain also report substance use disorder, compared to only 10.6% of individuals without clinically recognized pain (P < 0.01). Those with co-morbid pain and substance use disorder were significantly more likely than their specialty care counterparts without co-morbid pain and substance disorders to be seen in the emergency room (56.5% vs. 36.6%, respectively, P < 0.01).

Conclusion

The findings suggest that CNMP is associated with an increase risk of substance abuse disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
EW376
Information
European Psychiatry , Volume 33 , Issue S1: Abstracts of the 24th European Congress of Psychiatry , March 2016 , pp. S206
Copyright
Copyright © European Psychiatric Association 2016
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