Women who focus negatively, magnify chronic pain, more likely to be taking prescribed opioids

June 15, 2017, American Society of Anesthesiologists

Female chronic pain sufferers who catastrophize, a psychological condition in which pain is exaggerated or irrationally focused on, not only report greater pain intensity, but are more likely to be taking prescribed opioids than men with the same condition, according to a study published Online First in Anesthesiology, the peer-reviewed medical journal of the American Society of Anesthesiologists (ASA).

"Our research underscores how psychological factors such as negative thoughts or emotions have the capacity to influence how we experience and the likelihood that someone will be taking prescribed opioids," said Beth Darnall, Ph.D., study co-author and clinical associate professor, Department of Anesthesiology, Perioperative and Pain Medicine at Stanford University School of Medicine, Palo Alto, California. "The findings suggest that and catastrophizing contribute to different patterns of prescribing for male and female patients, highlighting a potential need for examination and intervention in future studies."

Pain catastrophizing has been shown to have a powerful influence on patients' sensory perception, and may explain up to 20 percent of the variance in intensity seen, with people who catastrophize experiencing greater pain intensity. This can ultimately influence pain treatment.

In a retrospective study, clinical data from nearly 1,800 adult was examined. All patients sought initial evaluation at a large outpatient pain treatment center between January 2014 and April 2015. Patient and non-patient reported data, such as average pain intensity, pain catastrophizing scale, sex, etc., was collected through Stanford's Pain Collaborative Health Outcomes Information Registry (CHOIR). Patients self-reported all current opioid prescription data either through CHOIR or verbally to clinic staff. Researchers used the data to characterize relationships between pain intensity, pain catastrophizing and opioid prescriptions - and to understand differences between these variables in men and women.

The study found that most patients examined (57 percent) were prescribed at least one opioid medication. For women, pain catastrophizing was more strongly associated with having an opioid prescription, and this pattern emerged in women with even relatively low levels of pain catastrophizing. Pain catastrophizing was the strongest predictor of prescribed opioids in women, while pain intensity was a stronger predictor of opioid prescription in men.

"Our findings show that even relatively low levels of negative cognitive and emotional responses to pain may have a great impact on opioid prescribing in women," said Yasamin Sharifzadeh, B.S., study lead author and second-year medical student at Virginia Commonwealth University, Richmond, Virginia. "We hope to study whether early treatment for pain catastrophizing may reduce opioid prescriptions for both sexes, particularly for women. As the impact of chronic pain grows, it is vital that we understand the nuances of how it affects different populations and how to best intervene."

The authors note that while replication of their results is needed, the findings suggest several important points:

  • First, clinicians should treat pain catastrophizing at low levels and as early as possible.
  • Second, the study adds to the existing evidence that the consequences of pain catastrophizing may be greater for women, so they are a particularly important target group for treatment.
  • Third, more research is needed to understand sex differences in pain so clinicians can develop better treatments for both men and .

Explore further: Worse pain outcomes after knee replacement for patients who took opioids before surgery

More information: Yasamin Sharifzadeh et al. Pain Catastrophizing Moderates Relationships between Pain Intensity and Opioid Prescription, Anesthesiology (2017). DOI: 10.1097/ALN.0000000000001656

Related Stories

Worse pain outcomes after knee replacement for patients who took opioids before surgery

May 18, 2017
Six months after knee replacement surgery, pain outcomes were not as good for patients who previously took prescription opioids, according to a study in the May 17 issue of The Journal of Bone & Joint Surgery.

How doubts about getting better influence chronic pain treatment success

May 16, 2017
A leading psychology professor at The University of Texas at Arlington has focused international attention on how a chronic pain patient's irrational doubts about never getting better can influence both his reactions to pain ...

Investigators examine the relationship between pain and opioid abuse

June 12, 2017
The drug overdose epidemic is largely driven by opioids, which continue to be prescribed for chronic pain despite recommendations to use non-opioids for most cases. A new review published in the British Journal of Pharmacology ...

Opioids following cesarean delivery may be over-prescribed

June 8, 2017
Cesarean delivery is the most common inpatient surgical procedure in the United States, with 1.4 million c-sections performed each year. Opioids, most commonly oxycodone, are the standard pain medications prescribed to women ...

Pain linked to non-medical prescription opioid use in young adults

May 17, 2017
Physical pain—often "self-medicated" without help from healthcare professionals—is an important contributor to non-medical prescription opioid (NMPO) use by young adults, suggests a study in the Journal of Addiction Medicine, ...

Catastrophizing can predict low back pain, disability

March 3, 2014
(HealthDay)—For patients treated for low back pain, catastrophizing may predict the degree of pain and disability, according to a review published in the Feb. 1 issue of Spine.

Recommended for you

Health insurance plans may be fueling opioid epidemic

June 22, 2018
Health care insurers including Medicare, Medicaid and major private insurers have not done enough to combat the opioid epidemic, suggests a study led by researchers at Johns Hopkins Bloomberg School of Public Health.

Overdose risk quintuples with opioid and benzodiazepine use

June 22, 2018
In the first 90 days of concurrent opioid and benzodiazepine use, the risk of opioid-related overdose increases five-fold compared to opioid-only use among Medicare recipients, according to a new study from the University ...

Discovery opens door for synthetic opioids with less addictive qualities

June 1, 2018
Making opioids from sugar instead of from field grown opium poppies has the potential to solve many of the problems associated with manufacturing strong pain killers.

US doctors prescribing fewer opioid painkillers: report

May 31, 2018
US doctors reduced the number of prescriptions for opioid painkillers last year, continuing a five-year trend, in an effort to reverse a deadly drug abuse epidemic, a report released Thursday said.

Researchers publish study on new therapy to treat opioid use disorder

May 22, 2018
Better delivery of medications to treat opioid use disorder (OUD) is key to addressing the opioid crisis and helping the 2.6 million Americans affected by the disease.

Could nonprofit drug companies cut sky-high prices?

May 17, 2018
(HealthDay)—Generic prescription drugs should be cheap, but prices for some have soared in the United States in recent years. Now a group of U.S. hospitals thinks it has a solution: a nonprofit drug maker.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.