Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, Columbus, OH, USA.
Department of Internal Medicine, Division of General Medicine, University of Michigan, Ann Arbor, MI, USA.
Ann Med. 2024 Dec;56(1):2422050. doi: 10.1080/07853890.2024.2422050. Epub 2024 Nov 5.
BACKGROUND/OBJECTIVES: Chronic pain is an opioid use disorder (OUD) treatment barrier and associated with poor outcomes in OUD treatment including relapse. Fibromyalgia is a chronic pain condition related to central nervous system substrates that overlap with the brain disease model of OUD. We know of no studies that have looked at non-treatment seeking individuals, to see if fibromyalgia might represent a barrier to OUD treatment. Given many non-treatment-seeking individuals previously attempted recovery before experiencing relapse, and chronic pain is a known precipitant of relapse, fibromyalgia might be a currently unappreciated modifiable factor in OUD relapse and, potentially, a barrier to treatment reengagement among those not currently seeking treatment. This study aimed to determine if fibromyalgia is associated with greater odds of agreeing that
This cross-sectional study recruited non-treatment-seeking individuals with OUD ( = 141) from a syringe service program. Ordinal logistic regression was used to determine if the presence of fibromyalgia increased the odds of agreement with prior pain-precipitated relapse.
Fibromyalgia was identified in 35% of study participants and associated with 125% greater odds of strongly agreeing that pain had previously caused them to relapse, even after accounting for relevant covariates, including age, sex, depression, anxiety, OUD severity, and pain severity.
This study provides early evidence that the presence of fibromyalgia may be associated with increased odds of pain-precipitated OUD relapse.
背景/目的：慢性疼痛是阿片类药物使用障碍（OUD）治疗的障碍，并与 OUD 治疗的不良结局相关，包括复发。纤维肌痛是一种与中枢神经系统基质相关的慢性疼痛病症，与 OUD 的大脑疾病模型重叠。我们不知道有任何研究关注过未接受治疗的个体，以了解纤维肌痛是否可能成为 OUD 治疗的障碍。鉴于许多未接受治疗的个体在经历复发之前曾尝试过康复，并且慢性疼痛是复发的已知诱因，纤维肌痛可能是 OUD 复发中目前尚未被认识到的可改变因素，并且可能是那些目前未寻求治疗的人重新参与治疗的障碍。本研究旨在确定纤维肌痛是否与更大的可能性相关，即同意以下观点：
这项横断面研究从一个注射器服务项目中招募了患有 OUD（ = 141）的未接受治疗的个体。有序逻辑回归用于确定纤维肌痛的存在是否会增加对先前由疼痛引发的复发的强烈同意的可能性。
研究参与者中有 35%被诊断出患有纤维肌痛，并且即使在考虑了相关协变量（包括年龄、性别、抑郁、焦虑、OUD 严重程度和疼痛严重程度）后，他们强烈同意疼痛先前导致他们复发的可能性也增加了 125%。
这项研究提供了早期证据，表明纤维肌痛的存在可能与增加由疼痛引发的 OUD 复发的可能性相关。
