TY - JOUR
T1 - Systematic review of prevalence, correlates, and treatment outcomes for chronic non-cancer pain in patients with comorbid substance use disorder
AU - Morasco, Benjamin J.
AU - Gritzner, Susan
AU - Lewis, Lynsey
AU - Oldham, Robert
AU - Turk, Dennis C.
AU - Dobscha, Steven K.
N1 - Funding Information:
This study was supported in part by award months, Dr. Turk has received research support from K23DA023467 from the National Institute on Drug Abuse to Dr. Morasco. During the past 12 Endo , Johnson & Johnson , Philips Respironics , and the National Institutes of Health , and consulting fees from Eli Lilly, Empi, Johnson & Johnson, Pfizer, Philips Respironics, and SK LifeScience. He is also a Special Government Employee of the US Food and Drug Administration. We appreciate the assistance of Mark Helfand, M.D., Devan Kansagara, M.D., and Roger Chou, M.D., for help in drafting or editing the key questions, Michele Freeman, M.P.H. for technical assistance, and research librarians Rose Campbell and Andrew Hamilton for developing the literature search strategies. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, Department of Veterans Affairs, US Food and Drug Administration, or another private entity.
PY - 2011/3
Y1 - 2011/3
N2 - Recent data suggest that comorbid substance use disorders (SUDs) are common among chronic non-cancer pain (CNCP) patients; however, prevalence rates vary across studies and findings are limited regarding treatment options for CNCP patients with comorbid SUD. The purpose of this systematic review is to assess the prevalence, associated demographic and clinical characteristics, and treatment outcomes for CNCP patients with comorbid SUD. We conducted searches from Ovid MEDLINE, PsychINFO, and PubMED from 1950 through February 2010 and retrieved the references. Thirty-eight studies met inclusion criteria and provided data that addressed our key questions. Three to forty-eight percent of CNCP patients have a current SUD. There are no demographic or clinical factors that consistently differentiate CNCP patients with comorbid SUD from patients without SUD, though SUD patients appear to be at greater risk for aberrant medication-related behaviors. CNCP patients with SUD are more likely to be prescribed opioid medications and at higher doses than CNCP patients without a history of SUD. CNCP patients with comorbid SUD do not significantly differ in their responses to treatment compared to CNCP patients without SUD, though the quality of this evidence is low. Limited data are available to identify predictors of treatment outcome. Although clinical experience and research suggests that SUDs are common among CNCP patients, only limited data are available to guide clinicians who treat this population. Research is needed to increase understanding of the prevalence, correlates, and responses to treatment of CNCP patients with comorbid SUDs.
AB - Recent data suggest that comorbid substance use disorders (SUDs) are common among chronic non-cancer pain (CNCP) patients; however, prevalence rates vary across studies and findings are limited regarding treatment options for CNCP patients with comorbid SUD. The purpose of this systematic review is to assess the prevalence, associated demographic and clinical characteristics, and treatment outcomes for CNCP patients with comorbid SUD. We conducted searches from Ovid MEDLINE, PsychINFO, and PubMED from 1950 through February 2010 and retrieved the references. Thirty-eight studies met inclusion criteria and provided data that addressed our key questions. Three to forty-eight percent of CNCP patients have a current SUD. There are no demographic or clinical factors that consistently differentiate CNCP patients with comorbid SUD from patients without SUD, though SUD patients appear to be at greater risk for aberrant medication-related behaviors. CNCP patients with SUD are more likely to be prescribed opioid medications and at higher doses than CNCP patients without a history of SUD. CNCP patients with comorbid SUD do not significantly differ in their responses to treatment compared to CNCP patients without SUD, though the quality of this evidence is low. Limited data are available to identify predictors of treatment outcome. Although clinical experience and research suggests that SUDs are common among CNCP patients, only limited data are available to guide clinicians who treat this population. Research is needed to increase understanding of the prevalence, correlates, and responses to treatment of CNCP patients with comorbid SUDs.
KW - Chronic pain
KW - Opioids
KW - Quality of life
KW - Substance use disorder
KW - Systematic review
KW - Treatment outcomes
UR - http://www.scopus.com/inward/record.url?scp=79851512311&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79851512311&partnerID=8YFLogxK
U2 - 10.1016/j.pain.2010.10.009
DO - 10.1016/j.pain.2010.10.009
M3 - Article
C2 - 21185119
AN - SCOPUS:79851512311
SN - 0304-3959
VL - 152
SP - 488
EP - 497
JO - Pain
JF - Pain
IS - 3
ER -