Chronic Pain Linked to Self-Medication in Fentanyl Users
A significant association was found between self-medication and chronic pain among primary fentanyl users in British Columbia, according to a recent cross-sectional survey published in the European Journal of Pain.
“Our results highlight that chronic pain is a common phenomenon among people using fentanyl, and that the severity of pain is often addressed by self-medication. Addressing the barrier of uncontrolled pain will be critical to reduce the risks of street opioid use as well as improve adherence to [opioid agonist treatment],” authors noted. “A multifaceted approach of maintenance therapy coupled with adjunctive pharmacological, psychological, and social treatment may be helpful to manage comorbid pain and decrease its large burden in this population.”
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Researchers conducted a cross-sectional and structured survey with 200 adults who reported fentanyl as their drug of choice from a Vancouver acute care hospital. Participants self-reported their chronic pain levels.
Most participants (n = 130, 72.6%) reported having chronic pain in the past 6 months, with the mean level of pain being 7.6 out of 10 (SD = 1.9). The majority (n = 85, 65.4%) reported using street opioids to self-medicate, while only 9 (6.9%) reported that their chronic pain was unrelated. Regression analysis showed that increasing age and co-use of cannabis and opioids were independent associated factors of chronic pain. Higher levels of reported pain were further associated with age and self-medication.
Researchers noted that the cross-sectional design of the survey prevents causal inferences, all participants being from one hospital site limits generalizability, and the self-reported data from participants may be subject to response bias. All these factors may limit study results.
“As the proliferation of fentanyl continues, interventions that address patient needs and improve engagement are more critical than ever,” authors concluded.
