Opioids are commonly prescribed for the management of patients with chronic noncancer
pain. Despite the potential analgesic benefits of opioids, long-term opioid therapy
(LTOT) may be accompanied by problems such as opioid misuse and opioid use disorder
(OUD). In this review, we begin with a description of opioid misuse and OUD and the
patient-specific factors associated with these problems among patients with chronic
pain. We will focus primarily on highlighting the predominant role played by psychological
factors in the occurrence of opioid misuse and OUD in these patients. Several psychological
factors have been found to be associated with opioid use problems in patients with
chronic pain, and evidence indicates that patients presenting with psychological disturbances
are particularly at risk of transitioning to long-term opioid use, engaging in opioid
misuse behaviors, and developing OUD. The biological factors that might underlie the
association between psychological disturbances and opioid use problems in patients
with chronic pain have yet to be fully elucidated, but a growing number of studies
suggest that dysfunctions in reward, appetitive, autonomic, and neurocognitive systems
might be involved. We end with an overview of specific types of psychological interventions
that have been put forward to prevent or reduce the occurrence of opioid misuse and
OUD in patients with chronic pain who are prescribed LTOT.
Abbreviations:
LTOT (Long-term opioid therapy), OUD (Opioid use disorder)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 03, 2021
Accepted:
February 26,
2021
Received in revised form:
February 26,
2021
Received:
December 22,
2020
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
