Treating Psychiatric Conditions Before Initiating Opioid Therapy for Chronic Back Pain

New research published in the July 3 Online First edition of the journal Anesthesiology concludes that the effectiveness of opioid therapy for chronic low back pain is significantly compromised in patients with depressive or anxiety-related comorbidities. Additionally, these patients are more likely to exhibit patterns of medication abuse. Lead author Ajay Wasan, MD, professor of anesthesiology and psychiatry at the University of Pittsburgh School of Medicine, observed, “High levels of depression and anxiety are common in patients with chronic lower back pain. Learning that we are able to better predict treatment success or failure by identifying patients with these conditions is significant.”

Wasan noted that the findings could be of substantial value in refining prescribing decisions, given the known risks of addition and adverse effects associated with opioid therapy. “It’s important for physicians to identify psychiatric disorders prior to deciding whether to prescribe opioids for chronic back pain as well as treat these conditions as part of a multimodal treatment plan,” he said. “Rather than refusing to prescribe opioids, we suggest that these conditions be treated early and preferably before lower back pain becomes chronic. For those prescribed opioids, successful treatment of underlying psychiatric disorders may improve pain relief and reduce the chance of opioid abuse in these patients.”

Read the Pain Reporter interview about CCBT for chronic back pain.

Read the Daily Dose about psychological stress and chronic back pain.

Do smokers have more back pain?

Read a news story about the study finding above, here.

The journal abstract may be read here.

For more information to articles about opioid therapy, click here.



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