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阿片类药物使用障碍和慢性疼痛患者在丁丙诺啡维持治疗期间的疼痛变化。

Changes in pain during buprenorphine maintenance treatment among patients with opioid use disorder and chronic pain.

作者信息

Edwards Karlyn A, Vowles Kevin E, McHugh R Kathryn, Venner Kamilla L, Witkiewitz Katie

机构信息

Department of Anesthesiology, Preoperative, and Pain Medicine.

School of Psychology.

出版信息

J Consult Clin Psychol. 2022 Apr;90(4):314-325. doi: 10.1037/ccp0000692. Epub 2022 Jan 10.

Abstract

OBJECTIVE

Opioid use disorder (OUD) and chronic pain frequently co-occur. Little is known about changes in pain during buprenorphine/naloxone (BUP/NX) maintenance and whether outcomes vary by pain levels. The present study examined changes in pain intensity and pain interference over 12 weeks of BUP/NX maintenance among participants with OUD and chronic pain ( = 194). Differences in outcomes were assessed during BUP/NX maintenance (Week 12) and 2 months following a BUP/NX taper (Week 24).

METHOD

Data from Phase 2 of the Prescription Opioid Addiction Treatment Study (POATS) were used. Two latent transition models were conducted to characterize profiles and transitions between profiles of pain intensity or pain interference (estimated separately).

RESULTS

Each model identified a high and low profile. In the pain interference model, the majority were classified in the low profile at baseline. In the pain intensity model, the majority were classified in the high profile at baseline. In both models, patients were more likely to remain in or transition to the low profiles by Week 12. Worse depression was associated with membership in the high pain interference profile at both timepoints. Women were more likely to be in the high pain intensity profile at baseline. Those in the high pain intensity and high pain interference profiles at Week 12 reported worse mental health quality of life (MH-QOL) at Week 12, as well as high pain intensity and high pain interference at Week 24.

CONCLUSIONS

For a subgroup of patients, high pain intensity and high pain interference remains unchanged during BUP/NX maintenance treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

摘要

目的

阿片类物质使用障碍(OUD)与慢性疼痛经常同时出现。关于丁丙诺啡/纳洛酮(BUP/NX)维持治疗期间疼痛的变化以及结果是否因疼痛程度而异,人们了解甚少。本研究调查了患有OUD和慢性疼痛的参与者(n = 194)在BUP/NX维持治疗1周期间疼痛强度和疼痛干扰的变化。在BUP/NX维持治疗期间(第12周)和BUP/NX减量后2个月(第24周)评估结果差异。

方法

使用处方阿片类物质成瘾治疗研究(POATS)第2阶段的数据。进行了两个潜在转变模型,以描述疼痛强度或疼痛干扰(分别估计)的概况和概况之间的转变。

结果

每个模型都识别出一个高概况和一个低概况。在疼痛干扰模型中,大多数人在基线时被归类为低概况。在疼痛强度模型中,大多数人在基线时被归类为高概况。在两个模型中,到第12周时,患者更有可能保持在低概况或转变为低概况。在两个时间点,更严重的抑郁都与高疼痛干扰概况相关。女性在基线时更有可能处于高疼痛强度概况。在第12周处于高疼痛强度和高疼痛干扰概况的人在第12周报告了较差的心理健康生活质量(MH-QOL),以及在第24周时的高疼痛强度和高疼痛干扰。

结论

对于一部分患者,在BUP/NX维持治疗期间,高疼痛强度和高疼痛干扰保持不变。(PsycInfo数据库记录(c)2022美国心理学会,保留所有权利)

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