Department of Anesthesiology & Critical Care Medicine, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287, USA; Center for Drug Safety and Effectiveness, Johns Hopkins School of Public Health, 615 N. Wolfe Street W6035 Baltimore, MD 21205, USA.
Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway Street, Baltimore, MD, 21205, USA.
Addict Behav. 2020 Mar;102:106172. doi: 10.1016/j.addbeh.2019.106172. Epub 2019 Oct 23.
Despite rising morbidity and mortality from the opioid epidemic and other addictions, people who inject drugs (PWID) remain understudied regarding pain outcomes. Data among PWID regarding chronic pain and drug use, including non-medical use of opioids, is largely unknown. We examined the prevalence of chronic pain and drug use for pain in this population.
Standardized surveys captured self-report of demographics, chronic pain, and non-prescription drug use in 203 PWID in an urban syringe services program between April and November 2016. Chronic pain was defined as self-report of chronic pain diagnosis or persistent pains over the past 6 months.
Overall, 47% (95% CI, 40%-54%) of PWID reported chronic pain, while 35% (95% CI, 29%-42%) reported non-prescription drug use of any type for pain. Among those with chronic pain, drug use to treat pain was commonly reported (76%; 95% CI, 66%-83%). Non-medical opioid use did not differ among PWID with or without chronic pain or drug use for pain. A multivariable logistic regression model showed chronic pain was more likely among non-Hispanic whites and those with arthritis, older age, and homelessness.
Chronic pain serves as an important factor in the persistence of drug use in more than one-third of PWID in this sample. The high prevalence of chronic pain with drug use for pain suggests that proper pain management is likely to be an essential component of preventing or regressing injection drug use in PWID, with data needed on effective interventions for this population.
尽管阿片类药物流行和其他成瘾导致发病率和死亡率上升，但在研究注射吸毒者（PWID）的疼痛结果方面，他们仍然研究不足。关于 PWID 的慢性疼痛和药物使用的数据，包括非医疗用途的阿片类药物，在很大程度上尚不清楚。我们研究了该人群中慢性疼痛和药物使用（包括非医疗用途的阿片类药物）用于治疗疼痛的流行情况。
2016 年 4 月至 11 月期间，在一个城市注射器服务计划中，对 203 名 PWID 进行了标准化调查，以收集人口统计学、慢性疼痛和非处方药物使用情况的自我报告。慢性疼痛的定义为自我报告的慢性疼痛诊断或过去 6 个月持续疼痛。
总体而言，47%（95%CI，40%-54%）的 PWID 报告有慢性疼痛，而 35%（95%CI，29%-42%）报告有任何类型的非处方药物用于治疗疼痛。在有慢性疼痛的人群中，经常报告有药物用于治疗疼痛（76%；95%CI，66%-83%）。有或没有慢性疼痛或药物用于治疗疼痛的 PWID 之间，非医疗用途的阿片类药物使用没有差异。多变量逻辑回归模型显示，非西班牙裔白人、有骨关节炎、年龄较大和无家可归的人群中，慢性疼痛更常见。
在本研究样本中，超过三分之一的 PWID 中，慢性疼痛是导致药物持续使用的一个重要因素。慢性疼痛和药物用于治疗疼痛的高患病率表明，适当的疼痛管理可能是预防或减少 PWID 注射药物使用的重要组成部分，需要针对这一人群的数据来确定有效的干预措施。
