Opioid Misuse and Distress Intolerance: What's the Link?
A study in The Journal of Pain found that the inability to manage negative emotional and somatic stress is tied to opioid misuse in adults with chronic pain.
Study authors from Harvard Medical School, Brigham and Women's Hospital, and McLean Hospital evaluated whether high distress intolerance would cause patients with chronic pain to misuse opioid analgesics more. Distress intolerance is defined as the perceived or actual inability to cope with adverse somatic or emotional stress. Earlier studies had suggested that those with chronic pain who misuse opioids generally showed higher levels of distress and heightened reactivity to that distress. Distress intolerance can be treated with cognitive behavioral therapy.
Researchers hypothesized that study individuals with higher distress intolerance levels would be more likely to misuse their prescribed opioids. The study also looked at whether stress intolerance was associated with high pain sensitivity.
Fifty-one patients completed questionnaires and self reports regarding pain severity, pain thresholds, distress intolerance, and opioid misuse. The data showed that self-reported distress intolerance was significantly associated with opioid misuse in the study sample. Every 1-unit increase in the Distress Intolerance Index increased the likelihood of being in the opioid misuse group by 12%. Of the total study participants, 31 met the criteria for opioid misuse.
Distress intolerance was not associated with greater pain sensitivity but rather associated with higher pain-related anxiety.
Lead author, R. Kathryn McHugh, PhD, added, "Distress intolerance may be a relevant marker of risk for opioid misuse among those with chronic pain."
For more information visit americanpainsociety.org.