Martel Marc O, Jamison Robert N, Wasan Ajay D, Edwards Robert R
Department of Anesthesiology, Harvard Medical School, Brigham & Women's Hospital, Boston, Massachusetts, USA.
Pain Med. 2014 Oct;15(10):1757-64. doi: 10.1111/pme.12416. Epub 2014 Mar 10.
A growing number of studies have shown that opioid craving (i.e., the perceived need or desire to consume opioids) is one of the strongest determinants of prescription opioid misuse in patients with chronic pain prescribed opioid therapy. To date, however, the factors that are associated with craving in patients with pain remain largely unexplored. Based on previous research, there is reason to believe that catastrophizing might be associated with heightened opioid craving.
To test the hypothesis that catastrophizing would be associated with heightened craving in patients with chronic pain prescribed long-term opioid therapy.
DESIGN AND SUBJECTS, AND METHODS: In this cross-sectional study, 109 patients with chronic pain were asked to provide self-reports of catastrophizing and craving. Patients also provided self-reports of pain intensity and depressive symptoms.
We found that higher levels of catastrophizing were associated with higher levels of craving. Importantly, results of a regression analysis revealed that the association between catastrophizing and craving remained significant even after controlling for a host of demographic (i.e., age, sex), psychological (i.e., depressive symptoms), medical (i.e., pain intensity, pain duration), and medication regimen (i.e., opioid doses) variables.
Our preliminary findings provide valuable new insights into the determinants of craving in patients with pain. The finding that catastrophizing was associated with craving even after controlling for a host of demographic, psychological, medical, and medication regimen variables is particularly striking, and raises questions concerning the factors that underlie the association between catastrophizing and craving in patients prescribed opioid therapy.
越来越多的研究表明，阿片类药物渴求（即感觉需要或渴望使用阿片类药物）是接受阿片类药物治疗的慢性疼痛患者滥用处方阿片类药物的最强决定因素之一。然而，迄今为止，与疼痛患者的渴求相关的因素在很大程度上仍未得到探索。基于先前的研究，有理由相信灾难化思维可能与阿片类药物渴求加剧有关。
检验灾难化思维与接受长期阿片类药物治疗的慢性疼痛患者的渴求加剧相关这一假设。
设计、研究对象与方法：在这项横断面研究中，109名慢性疼痛患者被要求提供关于灾难化思维和渴求的自我报告。患者还提供了疼痛强度和抑郁症状的自我报告。
我们发现，更高水平的灾难化思维与更高水平的渴求相关。重要的是，回归分析结果显示，即使在控制了一系列人口统计学（即年龄、性别）、心理（即抑郁症状）、医学（即疼痛强度、疼痛持续时间）和用药方案（即阿片类药物剂量）变量后，灾难化思维与渴求之间的关联仍然显著。
我们的初步研究结果为疼痛患者渴求的决定因素提供了有价值的新见解。即使在控制了一系列人口统计学、心理、医学和用药方案变量后，灾难化思维仍与渴求相关，这一发现尤为引人注目，并引发了关于在接受阿片类药物治疗的患者中灾难化思维与渴求之间关联背后因素的问题。
