This study evaluated the prevalence and correlates of aberrant drug-taking
behaviors in two populations: patients with HIV-related pain and a history of
substance abuse (n = 73) and patients with cancer pain and no history of substance
abuse (n = 100). All patients completed a Drug-Taking Behaviors Interview, the
Brief Symptom Inventory (BSI), Brief Pain Inventory (BPI), Memorial Symptom
Assessment Scale (MSAS), and the Marlowe Crowne Social Desirability Scale (MCSDS).
The Pain Management Index was calculated to assess the adequacy of opioid prescribing.
Patients with AIDS-related pain had higher global distress on the MSAS, greater
pain-related interference in their daily functioning on the BPI, and a lower
percentage of relief from their current medications. Patients with AIDS also
reported more than twice as many examples of aberrant drug-related behaviors
per patient as the cancer patients. The researchers conclude that AIDS patients
with histories of substance abuse receiving opioid therapy have more symptoms
and more distress, experience more interference from residual pain, and engage
in more problematic drug-related behaviors than patients with no history of
drug abuse receiving opioids for cancer pain. Treatment of substance abusers
with pain requires skills that complement best practices in opioid prescribing.
Better approaches to the long-term treatment of these populations are needed.
Passik SD, Kirsh KL, Donaghy KB, Portenoy RK. Adapted from Clin J Pain. 2006
Feb;22(2):173-181.
Read more: PMID 16428952
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
Credit: PubMed, developed by the National Center for Biotechnology Information
(NCBI) at the
National Library of Medicine (NLM).
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