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EPA-1277 – Opioids: the Enemy or the Ally?

Published online by Cambridge University Press:  15 April 2020

A. Faulí Prats
Affiliation:
Anaesthesiology, Hospital Clinic de Barcelona, Barcelona, Spain
A. López Lazcano
Affiliation:
Psychology, Hospital Clinic de Barcelona, Barcelona, Spain
A. Lligoña Garreta
Affiliation:
Psychiatry, Hospital Clinic de Barcelona, Barcelona, Spain
S. Mansilla Sánchez
Affiliation:
Psychiatry, Hospital Clinic de Barcelona, Barcelona, Spain

Abstract

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Introduction:

Chronic pain is a prevalent condition worldwide. Opioids have beneficial effects when treating pain, but also involve risks. Opioid iatrogenic dependence(OID) is becoming more prevalent in western countries. Co-occurring psychiatric disorders are both among its predisposing factors and its complications.

Objectives:

To review factors predicting response to opioid treatment, especially those related with psychiatric comorbidities. We describe a case of OID as an example of the patient-type.

Aims:

Attention needs to be paid to OID considering its growing health impact.

Materials/Methods:

Throughout the case of a patient with chronic pain due to post-radiotherapic proctalgia, who suffered from depression and showed maladaptive personality traits, we describe a case of OID.

Results:

All patients assisted at our Pain Clinic have current or previous psychiatric disorders, and in almost half of the cases is major depression, as it happens in our case-example. Concomitant psychopharmacological treatment of opioid dependence and psychiatric comorbidities (including other drugs abuse/dependence) improves outcomes.

Conclusions:

A global view of the opioid-consumer that includes comorbid psychiatric conditions is needed.

Type
P01 - Addictive Behaviours
Copyright
Copyright © European Psychiatric Association 2014

References

Blair Smith, H., et al.Epidemiology of Chronic Pain. Systematic Reviews in Pain Research Ed IASP PRESS 2008, pp 247273Google Scholar
Wilsey, B.L.Psychological comorbidities predicting prescription opioide abuse among patients in chronic pain presenting to the emergency department. Pain Med. 2008 Nov; 9 (8): 11071117.CrossRefGoogle Scholar
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