Plesner K, Jensen H I, Højsted J
Multidisciplinary Pain Centre, Odense University Hospital, Odense C, Denmark.
Department of Anaesthesiology and Intensive Care, Vejle and Middelfart Hospitals, Vejle, Denmark.
Acta Anaesthesiol Scand. 2016 Aug;60(7):988-94. doi: 10.1111/aas.12741. Epub 2016 May 10.
Previous studies have demonstrated a positive association between smoking and addiction to opioids in patients with chronic non-malignant pain. This could be explained by a susceptibility in some patients to develop addiction. Another explanation could be that nicotine influences both pain and the opioid system. The objective of the study was to investigate whether smoking, former smoking ± nicotine use and nicotine dependence in patients with chronic non-malignant pain were associated with opioid use and addiction to opioids.
The study was a cross-sectional study carried out at a multidisciplinary Danish pain centre. All patients aged 18 or more in treatment at the pain centre on the 1st of September 2013 were invited to participate in the study.
A total of 98 patients (65%) participated in the study. The prevalence of current smokers was twice as high as in the general population. The prevalence of patients using opioids was 54% and the prevalence of addiction to opioids was 6%. No significant differences in addiction were found between the different smoking groups, but smokers and former smokers using nicotine tended to use opioids more frequently and at higher doses than never smokers and former smokers not using nicotine.
The study supports previous evidence that smoking is associated with chronic pain. Our data suggest that information about use of nicotine substitution in chronic non-malignant patients are relevant both in a clinical setting, but also in future studies of the association between smoking habits, pain and opioid use.
既往研究表明，慢性非恶性疼痛患者中，吸烟与阿片类药物成瘾之间存在正相关。这可能是由于部分患者易成瘾。另一种解释可能是尼古丁对疼痛和阿片类系统均有影响。本研究的目的是调查慢性非恶性疼痛患者的吸烟、既往吸烟±使用尼古丁及尼古丁依赖是否与阿片类药物使用及阿片类药物成瘾有关。
本研究为在丹麦一个多学科疼痛中心开展的横断面研究。邀请了2013年9月1日在该疼痛中心接受治疗的所有18岁及以上患者参与研究。
共有98名患者（65%）参与了研究。当前吸烟者的患病率是普通人群的两倍。使用阿片类药物的患者患病率为54%，阿片类药物成瘾的患病率为6%。不同吸烟组之间在成瘾方面未发现显著差异，但使用尼古丁的吸烟者和既往吸烟者比从不吸烟和不使用尼古丁的既往吸烟者更倾向于更频繁、更高剂量地使用阿片类药物。
本研究支持既往证据，即吸烟与慢性疼痛有关。我们的数据表明，关于慢性非恶性患者使用尼古丁替代疗法的信息在临床环境以及未来关于吸烟习惯、疼痛和阿片类药物使用之间关联的研究中均具有相关性。
