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Background: Individuals with chronic low back pain (CLBP) are commonly prescribed long-term opioid therapy (LTOT) for analgesia, placing this population at increased risk for opioid misuse and opioid use disorder. Acceptance of aversive experiences (e.g., chronic pain) and awareness of automatic thoughts and behaviors (i.e., automaticity) are two facets of dispositional mindfulness that may serve as protective mechanisms against opioid misuse risk. Therefore, the aim of the current study was to examine the differential contributions of these constructs to opioid misuse risk among adults with CLBP receiving LTOT.
Methods: Data were obtained from a sample of 770 adults with opioid-treated CLBP. Bivariate correlations and hierarchical linear regression analyses were used to determine whether chronic pain acceptance and awareness of automatic thoughts and behaviors explained a statistically significant portion of variance in opioid misuse risk after accounting for the effects of other relevant confounders.
Results: Hierarchical regression results revealed that chronic pain acceptance and awareness of automatic thoughts and behaviors contributed a significant portion in the variance of opioid misuse risk. Awareness of automatic thoughts and behaviors was negatively associated with opioid misuse risk, such that individuals with lower levels of awareness of automaticity were at higher risk of opioid misuse. By contrast, pain acceptance was not associated with opioid misuse.
Conclusions: Findings suggest that awareness of automaticity may buffer against opioid misuse risk. Interventions designed to strengthen awareness of automaticity (e.g., mindfulness-based interventions) might be especially efficacious among this population.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10714486 | PMC |
http://dx.doi.org/10.1016/j.drugalcdep.2023.109890 | DOI Listing |
Contemp Clin Trials
December 2024
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Background: Back pain is increasingly common, leading to more spine surgeries. While most people experience pain relief and improved function after surgery, many continue to suffer from chronic post-surgical pain (CPSP) with limited functional improvement. CPSP is often treated with opioids, raising concerns about misuse, poor functional outcomes, and broader public health impacts.
View Article and Find Full Text PDFBMC Psychiatry
December 2024
Department of Economics, University of Bergen, Postboks, Bergen, 7802, 5020, Norway.
Background: Opioid use disorders constitute a vast disease burden, need for comprehensive treatment, and substantial costs to individuals, families, and society. The multifaceted needs of people with opioid dependence call for integrated care. The study aims to assess the added value of an integrated medically assisted rehabilitation (MAR) program providing opioid agonist therapy for patients with opioid dependence as compared to the standard of care (SoC) in Norway.
View Article and Find Full Text PDFScand J Pain
January 2024
Department of Clinical Sciences Malmö, Center for Primary Health Care Research, Lund University, Jan Waldenströms Gata 35, 202 13 Malmö, Sweden.
Objectives: The efficacy of long-term opioid therapy (LTOT) in treating patients with chronic non-cancer pain (CnCP) is questionable, and the potential risks of adverse effects are well established. The aims were as follows: (1) compare characteristics in patients exposed to LTOT vs non-exposed. (2) Regarding opioid-exposed patients, describe characteristics of patients with risk factors for opioid use disorder or overdose in relation to opioid dosage.
View Article and Find Full Text PDFObjectives: The accurate identification of Emergency Department (ED) encounters involving opioid misuse is critical for health services, research, and surveillance. We sought to develop natural language processing (NLP)-based models for the detection of ED encounters involving opioid misuse.
Methods: A sample of ED encounters enriched for opioid misuse was manually annotated and clinical notes extracted.
BMC Psychiatry
December 2024
Suzhou Guangji Hospital, Suzhou, Jiangsu Province, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu Province, China.
Background: In observational studies, frailty has been strongly associated with mental disorders. However, the mechanisms underlying the association between frailty and mental disorders remain unclear.
Methods: We conducted a two-sample Mendelian randomization (MR) study to assess the causal relationship between frailty, as measured by the frailty index (FI), and ten common mental disorders.
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