Profile of Chronic Pain Patients With Opioid Withdrawal Syndrome According to Psychological Factors: A Latent Class Analysis.

OBJECTIVE

Withdrawal syndrome stands out as the strongest risk factor for prescription opioid-use disorder (POUD) and is related to psychological and pain impairment in the chronic pain population. This study aimed to identify profiles of chronic pain patients with opioid withdrawal based on psychological factors and to explore the association between the classes and demographic, clinical, and substance use variables.

METHOD

This cross-sectional descriptive study involved 391 patients, 221 with interdose withdrawal (mean age = 57.91±13.61 years; 68.3% female). Latent class analysis and bivariate and logistic regression analyses were performed.

RESULTS

Two latent classes were identified (Bayesian information criterion = 4020.72, entropy = .70, likelihood ratio tests < .01): Withdrawal syndrome with No Psychological Distress (WNPD; 45.2%, = 100) and Withdrawal syndrome with Psychological Distress (WPD; 54.8%, = 121). The WPD class was more likely to experience craving, anxiety, and depression and to report higher levels of pain intensity and interference ( < .01). Patients in this class were younger, visited a higher number of specialists, and showed higher rates of high-dose opioid use, misuse, moderate-severe POUD, and tobacco and anxiolytics use ( < .05). Only moderate-severe POUD (odds ratio [OR] = 2.64) and tobacco use (OR = 2.28) increased the risk of WPD class membership.

CONCLUSIONS

Although it is common for chronic pain patients to experience withdrawal symptoms during opioid treatment, more than half of the participants reported concomitant psychological distress. Establishing differential profiles can help to improve withdrawal syndrome management during the treatment of chronic pain with opioids.