Multidisciplinary Pain Centre, Rigshospitalet, Copenhagen University Hospital, Denmark National Institute of Public Health, University of Southern Denmark, Denmark Section of Palliative Medicine, Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Denmark Department of Clinical Medicine, Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark.
Pain. 2013 Dec;154(12):2677-2683. doi: 10.1016/j.pain.2013.07.046. Epub 2013 Jul 30.
The growing body of research showing increased opioid use in patients with chronic pain coupled with concerns regarding addiction encouraged the development of this population-based study. The goal of the study was to investigate the co-occurrence of indicators of addictive behaviors in patients with chronic non-cancer pain in long-term opioid treatment. The study combined data from the individual-based Danish Health Survey in 2010 and the official Danish health and socio-economic, individual-based registers. From a simple random sample of 25,000 adults (16 years or older) living in Denmark, 13,281 individuals were analyzed through multiple logistic regression analyses to assess the association between chronic pain (lasting ≥6 months), opioid use, health behavior, and body mass index. Six potential addictive behaviors were identified: daily smoking; high alcohol intake; illicit drug use in the past year; obesity; long-term use of benzodiazepines; and long-term use of benzodiazepine-related drugs. At least 2 of the 6 addictive behaviors were observed in 22.6% of the long-term opioid users with chronic pain compared with 11.5% of the non-opioid users with chronic pain and 8.9% of the individuals without chronic pain. Thus, a strong association was demonstrated between long-term opioid use and the clustering of addictive behaviors. An intricate relationship between chronic pain, opioid use, and addictive behaviors was observed in this study, which deserves both clinical attention and further research.
越来越多的研究表明，慢性疼痛患者的阿片类药物使用增加，同时也对成瘾问题产生了担忧，这促使开展了这项基于人群的研究。该研究的目的是调查长期使用阿片类药物治疗的慢性非癌痛患者中，与成瘾行为相关的指标同时出现的情况。该研究结合了 2010 年个体为基础的丹麦健康调查和官方丹麦健康和社会经济个体为基础的登记处的数据。从丹麦居住的 25000 名成年人（16 岁或以上）的简单随机样本中，通过多项逻辑回归分析对 13281 人进行了分析，以评估慢性疼痛（持续≥6 个月）、阿片类药物使用、健康行为和体重指数之间的关联。确定了 6 种潜在的成瘾行为：每日吸烟；大量饮酒；过去一年使用非法药物；肥胖；长期使用苯二氮䓬类药物；以及长期使用苯二氮䓬类相关药物。与慢性疼痛而非阿片类药物使用者（22.6%）和无慢性疼痛者（8.9%）相比，至少有 2 种上述 6 种成瘾行为在长期使用阿片类药物治疗慢性疼痛的患者中观察到。因此，长期使用阿片类药物与成瘾行为的聚集之间存在很强的关联。在这项研究中观察到慢性疼痛、阿片类药物使用和成瘾行为之间存在复杂的关系，这值得临床关注和进一步研究。
