nach oben

01.04.2024 | Chronic Pain Medicine (O Viswanath, Section Editor)

Assessing Risk Factors and Comorbidities in the Treatment of Chronic Pain: A Narrative Review

verfasst von: Sage V. Hebert, Melanie A. Green, Sydney A. Mashaw, William D. Brouillette, Angela Nguyen, Kylie Dufrene, Anitha Shelvan, Shilpadevi Patil, Shahab Ahmadzadeh, Sahar Shekoohi, Alan D. Kaye

Erschienen in: Current Pain and Headache Reports

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

Chronic pain affects a significant portion of the population globally, making it a leading cause of disability. Understanding the multifaceted nature of chronic pain, its various types, and the intricate relationship it shares with risk factors, comorbidities, and mental health issues like depression and anxiety is critical for comprehensive patient care. Factors such as socioeconomic status (SES), age, gender, and obesity collectively add layers of complexity to chronic pain experiences and pose management challenges.

Recent Findings

Low SES presents barriers to effective pain care, while gender differences and the prevalence of chronic pain in aging adults emphasize the need for tailored approaches. The association between chronic pain and physical comorbidities like cardiovascular disease, chronic obstructive pulmonary disease (COPD), and diabetes mellitus reveals shared risk factors and further highlights the importance of integrated treatment strategies. Chronic pain and mental health are intricately linked through biochemical mechanisms, profoundly affecting overall quality of life. This review explores pharmacologic treatment for chronic pain, particularly opioid analgesia, with attention to the risk of substance misuse and the ongoing opioid epidemic. We discuss the potential role of medical cannabis as an alternative treatment with a nuanced perspective on its impact on opioid use.

Summary

Addressing the totality and complexity of pain states is crucial to individualizing chronic pain management. With different types of pain having different underlying mechanisms, considerations should be made when approaching their treatment. Moreover, the synergistic relationship that pain states can have with other comorbidities further complicates chronic pain conditions.

Rikard SM. Chronic pain among adults — United States, 2019–2021. MMWR Morb Mortal Wkly Rep. 2023. https://doi.org/10.15585/mmwr.mm7215a1.CrossRefPubMedPubMedCentral

GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017 Sep 16;390(10100):1211–59. https://doi.org/10.1016/S0140-6736(17)32154-2. Erratum In: Lancet. 2017 Oct 28;390(10106):e38. PMID: 28919117; PMCID: PMC5605509.

Atta AA, Ibrahim WW, Mohamed AF, Abdelkader NF. Microglia polarization in nociplastic pain: mechanisms and perspectives. Inflammopharmacology. 2023;31(3):1053–67. https://doi.org/10.1007/s10787-023-01216-x.CrossRefPubMedPubMedCentral

Kosek E, Cohen M, Baron R, et al. Do we need a third mechanistic descriptor for chronic pain states? Pain. 2016;157(7):1382. https://doi.org/10.1097/j.pain.0000000000000507.CrossRefPubMed

• Bułdyś K, Górnicki T, Kałka D, et al. What do we know about nociplastic pain? Healthcare. 2023;11(12):1794. https://doi.org/10.3390/healthcare11121794. With nociplastic pain being a newly coined term and concept, there is still much debate about its role in various chronic pain states. Further research on the pathophysiology of nociplastic pain and a better understanding of its capacity could precipitate more efficient treatment options.CrossRefPubMedPubMedCentral

Dydyk AM, Conermann T. Chronic pain. In: StatPearls. StatPearls Publishing; 2024. Accessed 30 Jan 2024. http://www.ncbi.nlm.nih.gov/books/NBK553030/.

Guerriero F. Guidance on opioids prescribing for the management of persistent non-cancer pain in older adults. World J Clin Cases. 2017;5(3):73–81. https://doi.org/10.12998/wjcc.v5.i3.73.CrossRefPubMedPubMedCentral

Poleshuck EL, Green CR. Socioeconomic disadvantage and pain. Pain. 2008;136(3):235–8. https://doi.org/10.1016/j.pain.2008.04.003.CrossRefPubMedPubMedCentral

Janevic MR, McLaughlin SJ, Heapy AA, Thacker C, Piette JD. Racial and socioeconomic disparities in disabling chronic pain: findings from the Health and Retirement Study. J Pain. 2017;18(12):1459–67. https://doi.org/10.1016/j.jpain.2017.07.005.CrossRefPubMedPubMedCentral

10.

Hollingshead N, Matthias M, Bair M, Hirsh A. Healthcare providers’ perceptions of socioeconomically disadvantaged patients with chronic pain: a qualitative investigation. J Health Disparities Res Pract. 2016;9(3). https://digitalscholarship.unlv.edu/jhdrp/vol9/iss3/3.

11.

Nampiaparampil DE, Nampiaparampil JX, Harden RN. Pain and prejudice. Pain Med. 2009;10(4):716–21. https://doi.org/10.1111/j.1526-4637.2009.00612.x.CrossRefPubMed

12.

Summers KM, Deska JC, Almaraz SM, Hugenberg K, Lloyd EP. Poverty and pain: low-SES people are believed to be insensitive to pain. J Exp Soc Psychol. 2021;95: 104116. https://doi.org/10.1016/j.jesp.2021.104116.CrossRef

13.

Bartley EJ, Fillingim RB. Sex differences in pain: a brief review of clinical and experimental findings. BJA Br J Anaesth. 2013;111(1):52–8. https://doi.org/10.1093/bja/aet127.CrossRefPubMed

14.

Riley JL III, Robinson ME, Wise EA, Myers CD, Fillingim RB. Sex differences in the perception of noxious experimental stimuli: a meta-analysis. Pain. 1998;74(2):181–7. https://doi.org/10.1016/S0304-3959(97)00199-1.CrossRefPubMed

15.

El-Shormilisy N, Strong J, Meredith PJ. Associations among gender, coping patterns and functioning for individuals with chronic pain: a systematic review. Pain Res Manag J Can Pain Soc. 2015;20(1):48–55.CrossRef

16.

Racine M, Tousignant-Laflamme Y, Kloda LA, Dion D, Dupuis G, Choinière M. A systematic literature review of 10 years of research on sex/gender and pain perception – Part 2: do biopsychosocial factors alter pain sensitivity differently in women and men? Pain. 2012;153(3):619–35. https://doi.org/10.1016/j.pain.2011.11.026.CrossRefPubMed

17.

Hunt K, Adamson J, Hewitt C, Nazareth I. Do women consult more than men? A review of gender and consultation for back pain and headache. J Health Serv Res Policy. 2011;16(2):108–17. https://doi.org/10.1258/jhsrp.2010.009131.CrossRefPubMedPubMedCentral

18.

Larsson C, Hansson E, Sundquist K, Jakobsson U. Chronic pain in older adults: prevalence, incidence, and risk factors. Scand J Rheumatol. 2016;46:1–9. https://doi.org/10.1080/03009742.2016.1218543.CrossRef

19.

Lakha SF, Assimakopoulos D, Mailis A. Comparison of older and younger patients referred to a non-interventional community pain clinic in the Greater Toronto Area (GTA). Pain Ther. 2023;12(1):213–24. https://doi.org/10.1007/s40122-022-00435-4.CrossRefPubMed

20.

• Stokes AC, Xie W, Lunderberg DJ, et al. Increases in BMI and chronic pain for US adults in midlife 1992 to 2016 SSM. Popul Health. 2020;12:100644. https://doi.org/10.1016/j.ssmph.2020.100644. With obesity being an associated risk factor of both chronic pain and its common comorbidities, it is important to note potential correlation in the rising trends in these conditions.CrossRef

21.

Mancuso P. The role of adipokines in chronic inflammation. ImmunoTargets Ther. 2016;5:47–56. https://doi.org/10.2147/ITT.S73223.CrossRefPubMedPubMedCentral

22.

Hainsworth KR, Simpson PM, Raff H, Grayson MH, Zhang L, Weisman SJ. Circulating inflammatory biomarkers in adolescents: evidence of interactions between chronic pain and obesity. Pain Rep. 2021;6(1): e916. https://doi.org/10.1097/PR9.0000000000000916.CrossRefPubMedPubMedCentral

23.

Hitt HC, McMillen RC, Thornton-Neaves T, Koch K, Cosby AG. Comorbidity of obesity and pain in a general population: results from the Southern Pain Prevalence Study. J Pain. 2007;8(5):430–6. https://doi.org/10.1016/j.jpain.2006.12.003.CrossRefPubMed

24.

Reynolds CA, Minic Z. Chronic pain-associated cardiovascular disease: the role of sympathetic nerve activity. Int J Mol Sci. 2023;24(6):5378. https://doi.org/10.3390/ijms24065378.CrossRefPubMedPubMedCentral

25.

Hansen J, Molsted S, Ekholm O, Hansen H. Pain prevalence, localization, and intensity in adults with and without COPD: results from the Danish Health and Morbidity Survey (a Self-reported Survey). Int J Chron Obstruct Pulmon Dis. 2020;15:3303–11. https://doi.org/10.2147/COPD.S275234.CrossRefPubMedPubMedCentral

26.

Chopra S, Malhotra A, Ranjan P, Vikram NK, Singh N. Lifestyle-related advice in the management of obesity: a step-wise approach. J Educ Health Promot. 2020;9:239. https://doi.org/10.4103/jehp.jehp_216_20.CrossRefPubMedPubMedCentral

27.

Shahid S, Akhter Z, Sukaina M, Sohail F, Nasir F. Association of diabetes with lower back pain: a narrative review. Cureus. 2021;13(6):e15776. https://doi.org/10.7759/cureus.15776. PMID: 34295586; PMCID: PMC8291343.

28.

Small RN, Shergill Y, Tremblay S, et al. Understanding the impact of chronic pain in the emergency department: prevalence and characteristics of patients visiting the emergency department for chronic pain at an urban academic health sciences centre. Can J Pain. 2019;3(1):106–13. https://doi.org/10.1080/24740527.2019.1587290.CrossRefPubMedPubMedCentral

29.

Haase J, Brown E. Integrating the monoamine, neurotrophin and cytokine hypotheses of depression — a central role for the serotonin transporter? Pharmacol Ther. 2015;147:1–11. https://doi.org/10.1016/j.pharmthera.2014.10.002.CrossRefPubMed

30.

Bannister K, Bee LA, Dickenson AH. Preclinical and early clinical investigations related to monoaminergic pain modulation. Neurother J Am Soc Exp Neurother. 2009;6(4):703–12. https://doi.org/10.1016/j.nurt.2009.07.009.CrossRef

31.

Hammond DL, Tyce GM, Yaksh TL. Efflux of 5-hydroxytryptamine and noradrenaline into spinal cord superfusates during stimulation of the rat medulla. J Physiol. 1985;359:151–62. https://doi.org/10.1113/jphysiol.1985.sp015579.CrossRefPubMedPubMedCentral

32.

Sagheddu C, Aroni S, De Felice M, et al. Enhanced serotonin and mesolimbic dopamine transmissions in a rat model of neuropathic pain. Neuropharmacology. 2015;97:383–93. https://doi.org/10.1016/j.neuropharm.2015.06.003.CrossRefPubMed

33.

Glantz LA, Gilmore JH, Overstreet DH, Salimi K, Lieberman JA, Jarskog LF. Pro-apoptotic Par-4 and dopamine D2 receptor in temporal cortex in schizophrenia, bipolar disorder and major depression. Schizophr Res. 2010;118(1–3):292–9. https://doi.org/10.1016/j.schres.2009.12.027.CrossRefPubMedPubMedCentral

34.

De La Rosa JS, Brady BR, Ibrahim MM, et al. Co-occurrence of chronic pain and anxiety/depression symptoms in U.S. adults: prevalence, functional impacts, and opportunities. PAIN. Published online May 13, 2022:https://doi.org/10.1097/j.pain.0000000000003056.

35.

Kroenke K, Wu J, Bair MJ, Krebs EE, Damush TM, Tu W. Reciprocal relationship between pain and depression: a 12-month longitudinal analysis in primary care. J Pain. 2011;12(9):964–73. https://doi.org/10.1016/j.jpain.2011.03.003.CrossRefPubMedPubMedCentral

36.

Thielke SM, Fan MY, Sullivan M, Unützer J. Pain limits the effectiveness of collaborative care for depression. Am J Geriatr Psychiatry. 2007;15(8):699–707. https://doi.org/10.1097/JGP.0b013e3180325a2d.CrossRefPubMed

37.

Bair MJ, Robinson RL, Eckert GJ, Stang PE, Croghan TW, Kroenke K. Impact of pain on depression treatment response in primary care. Psychosom Med. 2004;66(1):17. https://doi.org/10.1097/01.PSY.0000106883.94059.C5.CrossRefPubMed

38.

Han H, Wang SM, Han C, Lee SJ, Pae CU. The relationship between somatic symptoms and depression. Neuro Endocrinol Lett. 2014;35:463–9.PubMed

39.

Arvidsson U, Dado R, Riedl M, et al. delta-Opioid receptor immunoreactivity: distribution in brainstem and spinal cord, and relationship to biogenic amines and enkephalin. J Neurosci. 1995;15(2):1215–35. https://doi.org/10.1523/JNEUROSCI.15-02-01215.1995.CrossRefPubMedPubMedCentral

40.

Lewis ME, Pert A, Pert CB, Herkenham M. Opiate receptor localization in rat cerebral cortex. J Comp Neurol. 1983;216(3):339–58. https://doi.org/10.1002/cne.902160310.CrossRefPubMed

41.

Mathieu-Kia AM, Fan LQ, Kreek MJ, Simon EJ, Hiller JM. μ-, δ- and κ-opioid receptor populations are differentially altered in distinct areas of postmortem brains of Alzheimer’s disease patients. Brain Res. 2001;893(1):121–34. https://doi.org/10.1016/S0006-8993(00)03302-3.CrossRefPubMed

42.

Pan YX, Pasternak GW. Molecular biology of mu opioid receptors. In: Pasternak GW, ed. The opiate receptors The Receptors Humana Press. 2011;121:160. https://doi.org/10.1007/978-1-60761-993-2_6.CrossRef

43.

Traynor JR, Wood MS. Distribution of opioid binding sites in spinal cord. Neuropeptides. 1987;10(4):313–20. https://doi.org/10.1016/S0143-4179(87)90065-5.CrossRefPubMed

44.

Garland EL, Froeliger B, Zeidan F, Partin K, Howard MO. The downward spiral of chronic pain, prescription opioid misuse, and addiction: cognitive, affective, and neuropsychopharmacologic pathways. Neurosci Biobehav Rev. 2013;7(10 0 2):2597–607. https://doi.org/10.1016/j.neubiorev.2013.08.006.CrossRef

45.

Becker S, Gandhi W, Schweinhardt P. Cerebral interactions of pain and reward and their relevance for chronic pain. Neurosci Lett. 2012;520(2):182–7. https://doi.org/10.1016/j.neulet.2012.03.013.CrossRefPubMed

46.

Fields HL. Mu opioid receptor mediated analgesia and reward. In: Pasternak GW, ed. The Receptors Humana Press. 2011;239:264. https://doi.org/10.1007/978-1-60761-993-2_10.CrossRef

47.

Julien RM. A primer of drug action: a concise nontechnical guide to the actions, uses, and side effects of psychoactive drugs, revised and updated. Henry Holt and Company; 2013.

48.

Johnson S, North R. Opioids excite dopamine neurons by hyperpolarization of local interneurons. J Neurosci. 1992;12(2):483–8. https://doi.org/10.1523/JNEUROSCI.12-02-00483.1992.CrossRefPubMedPubMedCentral

49.

Chiara GD, Alan NR. Neurobiology of opiate abuse. Trends Pharmacol Sci. 1992;13:185–93. https://doi.org/10.1016/0165-6147(92)90062-B.CrossRefPubMed

50.

Volkow ND, Wang GJ, Fowler JS, Tomasi D, Telang F. Addiction: beyond dopamine reward circuitry. Proc Natl Acad Sci U S A. 2011;108(37):15037–42. https://doi.org/10.1073/pnas.1010654108.CrossRefPubMedPubMedCentral

51.

Berridge KC, Robinson TE, Aldridge JW. Dissecting components of reward: ‘liking’, ‘wanting’, and learning. Curr Opin Pharmacol. 2009;9(1):65–73. https://doi.org/10.1016/j.coph.2008.12.014.CrossRefPubMedPubMedCentral

52.

Merrer JL, Becker JAJ, Befort K, Kieffer BL. Reward processing by the opioid system in the brain. Physiol Rev. 2009;89(4):1379–412. https://doi.org/10.1152/physrev.00005.2009.CrossRefPubMed

53.

Becerra L, Harter K, Gonzalez RG, Borsook D. Functional magnetic resonance imaging measures of the effects of morphine on central nervous system circuitry in opioid-naive healthy volunteers. Anesth Analg. 2006;103(1):208. https://doi.org/10.1213/01.ane.0000221457.71536.e0.CrossRefPubMed

54.

Jastrzab L, Mackey S, Chu L, Stringer E, Younger J. Neural correlates of opioid induced hyperalgesia. J Pain. 2012;13(4):S51. https://doi.org/10.1016/j.jpain.2012.01.216.CrossRef

55.

Wanigasekera V, Lee MC, Rogers R, et al. Baseline reward circuitry activity and trait reward responsiveness predict expression of opioid analgesia in healthy subjects. Proc Natl Acad Sci U S A. 2012;109(43):17705–10. https://doi.org/10.1073/pnas.1120201109.CrossRefPubMedPubMedCentral

56.

Lee MC, Wanigasekera V, Tracey I. Imaging opioid analgesia in the human brain. Trends Anaesth Crit Care. 2012;2(5):244–8. https://doi.org/10.1016/j.tacc.2012.07.002.CrossRef

57.

Breiter HC, Gollub RL, Weisskoff RM, et al. Acute effects of cocaine on human brain activity and emotion. Neuron. 1997;19(3):591–611. https://doi.org/10.1016/S0896-6273(00)80374-8.CrossRefPubMed

58.

Fiset P, Plourde G, Backman SB. Brain imaging in research on anesthetic mechanisms: studies with propofol. In: Laureys S, ed. Progress in brain research. Vol 150. The boundaries of consciousness: neurobiology and neuropathology. Elsevier; 2005:245–598. https://doi.org/10.1016/S0079-6123(05)50018-9.

59.

Wagner KJ, Sprenger T, Kochs EF, Tölle TR, Valet M, Willoch F. Imaging human cerebral pain, modulation by dose-dependent opioid analgesia: a positron emission tomography activation study using remifentanil. Anesthesiology. 2007;106(3):548–56. https://doi.org/10.1097/00000542-200703000-00020.CrossRefPubMed

60.

Oertel B, Preibisch C, Wallenhorst T, et al. Differential opioid action on sensory and affective cerebral pain processing. Clin Pharmacol Ther. 2008;83(4):577–88. https://doi.org/10.1038/sj.clpt.6100441.CrossRefPubMed

61.

Thayer JF, Lane RD. Claude Bernard and the heart–brain connection: further elaboration of a model of neurovisceral integration. Neurosci Biobehav Rev. 2009;33(2):81–8. https://doi.org/10.1016/j.neubiorev.2008.08.004.CrossRefPubMed

62.

Vallejo R. Pharmacology of opioids in the treatment of chronic pain syndromes. pain Physician. 2011;14(4):E343–60. https://doi.org/10.36076/ppj.2011/14/E343.CrossRefPubMed

63.

Dellemijn PL, Vanneste JA. Randomised double-blind active-placebo-controlled crossover trial of intravenous fentanyl in neuropathic pain. The Lancet. 1997;349(9054):753–8. https://doi.org/10.1016/S0140-6736(96)09024-1.CrossRef

64.

Ballantyne JC. Opioids for the treatment of chronic pain: mistakes made, lessons learned, and future directions. Anesth Analg. 2017;125(5):1769. https://doi.org/10.1213/ANE.0000000000002500.CrossRefPubMed

65.

Kucyi A, Davis KD. The dynamic pain connectome. Trends Neurosci. 2015;38(2):86–95. https://doi.org/10.1016/j.tins.2014.11.006.CrossRefPubMed

66.

Rivat C, Ballantyne J. The dark side of opioids in pain management: basic science explains clinical observation. Pain Rep. 2016;1(2): e570. https://doi.org/10.1097/PR9.0000000000000570.CrossRefPubMedPubMedCentral

67.

Ballantyne JC, Sullivan MD, Kolodny A. Opioid dependence vs addiction: a distinction without a difference? Arch Intern Med. 2012;172(17):1342–3. https://doi.org/10.1001/archinternmed.2012.3212.CrossRefPubMed

68.

Ballantyne JC, LaForge KS. Opioid dependence and addiction during opioid treatment of chronic pain. Pain. 2007;129(3):235–55. https://doi.org/10.1016/j.pain.2007.03.028.CrossRefPubMed

69.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.

70.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing; 2013.CrossRef

71.

Bolshakova M, Bluthenthal R, Sussman S. Opioid use and misuse: health impact, prevalence, correlates and interventions. Psychol Health. 2019;34(9):1105–39. https://doi.org/10.1080/08870446.2019.1622013.CrossRefPubMedPubMedCentral

72.

CDC. Disease of the Week - Opioid Use Disorder. Centers for Disease Control and Prevention. Published August 30, 2022. Accessed 22 Jan 2024.https://www.cdc.gov/drugoverdose/featured-topics/opioid-use-disorder/index.html.

73.

Imtiaz S, Shield KD, Fischer B, et al. Recent changes in trends of opioid overdose deaths in North America. Subst Abuse Treat Prev Policy. 2020;15:66. https://doi.org/10.1186/s13011-020-00308-z.CrossRefPubMedPubMedCentral

74.

Bohnert ASB, Valenstein M, Bair MJ, et al. Association between opioid prescribing patterns and opioid overdose-related deaths. JAMA. 2011;305(13):1315–21. https://doi.org/10.1001/jama.2011.370.CrossRefPubMed

75.

Imtiaz S, Shield KD, Fischer B, Rehm J. Harms of prescription opioid use in the United States. Subst Abuse Treat Prev Policy. 2014;9:43. https://doi.org/10.1186/1747-597X-9-43.CrossRefPubMedPubMedCentral

76.

Fischer B, Jones W, Rehm J. High correlations between levels of consumption and mortality related to strong prescription opioid analgesics in British Columbia and Ontario, 2005–2009. Pharmacoepidemiol Drug Saf. 2013;22(4):438–42. https://doi.org/10.1002/pds.3404.CrossRefPubMed

77.

Guy GP, Zhang K, Bohm MK, et al. Vital signs: changes in opioid prescribing in the United States, 2006–2015. Morb Mortal Wkly Rep. 2017;66(26):697–704. https://doi.org/10.15585/mmwr.mm6626a4.CrossRef

78.

Psaty BM, Merrill JO. Addressing the opioid epidemic — opportunities in the postmarketing setting. N Engl J Med. 2017;376(16):1502–4. https://doi.org/10.1056/NEJMp1614972.CrossRefPubMed

79.

Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain - United States, 2016. MMWR Recomm Rep Morb Mortal Wkly Rep Recomm Rep. 2016;65(1):1–49. https://doi.org/10.15585/mmwr.rr6501e1.CrossRef

80.

Meara E, Horwitz JR, Powell W, et al. State legal restrictions and prescription-opioid use among disabled adults. N Engl J Med. 2016;375(1):44–53. https://doi.org/10.1056/NEJMsa1514387.CrossRefPubMedPubMedCentral

81.

Rutkow L, Chang HY, Daubresse M, Webster DW, Stuart EA, Alexander GC. Effect of Florida’s prescription drug monitoring program and pill mill laws on opioid prescribing and use. JAMA Intern Med. 2015;175(10):1642–9. https://doi.org/10.1001/jamainternmed.2015.3931.CrossRefPubMed

82.

Reifler LM, Droz D, Bailey JE, et al. Do prescription monitoring programs impact state trends in opioid abuse/misuse? Pain Med. 2012;13(3):434–42. https://doi.org/10.1111/j.1526-4637.2012.01327.x.CrossRefPubMed

83.

Gomes T, Juurlink D, Yao Z, et al. Impact of legislation and a prescription monitoring program on the prevalence of potentially inappropriate prescriptions for monitored drugs in Ontario: a time series analysis. CMAJ Open. 2014;2(4):E256–61. https://doi.org/10.9778/cmajo.20140027.CrossRefPubMedPubMedCentral

84.

Frank RG, Pollack HA. Addressing the fentanyl threat to public health. N Engl J Med. 2017;376(7):605–7. https://doi.org/10.1056/NEJMp1615145.CrossRefPubMed

85.

Bains S, Mukhdomi T. Medicinal cannabis for treatment of chronic pain. In: StatPearls. StatPearls Publishing; 2023. Accessed 23 Jan 2024.http://www.ncbi.nlm.nih.gov/books/NBK574562/.

86.

Scott JR, Williams DA, Harte SE, et al. Relationship between nociplastic pain involvement and medication use, symptom relief, and adverse effects among people using medical cannabis for chronic pain. Clin J Pain. 2024;40(1):1. https://doi.org/10.1097/AJP.0000000000001164.CrossRefPubMed

87.

Piper BJ, Beals ML, Abess AT, et al. Chronic pain patients’ perspectives of medical cannabis. Pain. 2017;158(7):1373–9. https://doi.org/10.1097/j.pain.0000000000000899.CrossRefPubMedPubMedCentral

88.

Boehnke KF, Litinas E, Clauw DJ. Medical cannabis use is associated with decreased opiate medication use in a retrospective cross-sectional survey of patients with chronic pain. J Pain. 2016;17(6):739–44. https://doi.org/10.1016/j.jpain.2016.03.002.CrossRefPubMed

89.

Hsu G, Kovács B. Association between county level cannabis dispensary counts and opioid related mortality rates in the United States: panel data study. The BMJ. 2021;372: m4957. https://doi.org/10.1136/bmj.m4957.CrossRefPubMedPubMedCentral

90.

Okusanya BO, Asaolu IO, Ehiri JE, Kimaru LJ, Okechukwu A, Rosales C. Medical cannabis for the reduction of opioid dosage in the treatment of non-cancer chronic pain: a systematic review. Syst Rev. 2020;9:167. https://doi.org/10.1186/s13643-020-01425-3.CrossRefPubMedPubMedCentral

91.

Caputi TL, Humphreys K. Medical marijuana users are more likely to use prescription drugs medically and nonmedically. J Addict Med. 2018;12(4):295. https://doi.org/10.1097/ADM.0000000000000405.CrossRefPubMed

92.

Campbell G, Hall WD, Peacock A, et al. Effect of cannabis use in people with chronic non-cancer pain prescribed opioids: findings from a 4-year prospective cohort study. Lancet Public Health. 2018;3(7):e341–50. https://doi.org/10.1016/S2468-2667(18)30110-5.CrossRefPubMedPubMedCentral

93.

Olfson M, Wall MM, Liu SM, Blanco C. Cannabis use and risk of prescription opioid use disorder in the United States. Am J Psychiatry. 2018;175(1):47–53. https://doi.org/10.1176/appi.ajp.2017.17040413.CrossRefPubMed

94.

Gorfinkel LR, Stohl M, Greenstein E, Aharonovich E, Olfson M, Hasin D. Is Cannabis being used as a substitute for non-medical opioids by adults with problem substance use in the United States? A within-person analysis Addict Abingdon Engl. 2021;116(5):1113–21. https://doi.org/10.1111/add.15228.CrossRef

95.

Berardino K, Carroll AH, Ricotti R, Popovsky D, Civilette MD, Urits I, Viswanath O, Sherman WF, Kaye AD. The ramifications of opioid utilization and outcomes of alternative pain control strategies for total knee arthroplasties. Orthop Rev (Pavia). 2022;14(3):37496. https://doi.org/10.52965/001c.37496.PMID:36045694;PMCID:PMC9425522.CrossRefPubMed

96.

Kassem H, Urits I, Kaye AD, Viswanath O. Finding suitable alternatives to opioids for postoperative pain control. Pain Physician. 2020;23(1):E69–E70 Erratum in: Pain Physician. 2020 Mar;23(2):235. PMID: 32013293.CrossRefPubMed

97.

Gress K, Charipova K, Jung JW, Kaye AD, Paladini A, Varrassi G, Viswanath O, Urits I. A comprehensive review of partial opioid agonists for the treatment of chronic pain. Best Pract Res Clin Anaesthesiol. 2020;34(3):449–61. https://doi.org/10.1016/j.bpa.2020.06.003. (Epub 2020 Jul 2 PMID: 33004158).CrossRefPubMed

98.

Urits I, Patel A, Zusman R, Virgen CG, Mousa M, Berger AA, et al. A comprehensive update of lofexidine for the management of opioid withdrawal symptoms. Psychopharmacol Bull. 2020;50(3):76–96. PMID: 32733113; PMCID: PMC7377538.

99.

Mills SEE, Nicolson KP, Smith BH. Chronic pain: a review of its epidemiology and associated factors in population-based studies. BJA Br J Anaesth. 2019;123(2):e273–83. https://doi.org/10.1016/j.bja.2019.03.023.CrossRefPubMed

Titel: Assessing Risk Factors and Comorbidities in the Treatment of Chronic Pain: A Narrative Review
verfasst von: Sage V. Hebert
Melanie A. Green
Sydney A. Mashaw
William D. Brouillette
Angela Nguyen
Kylie Dufrene
Anitha Shelvan
Shilpadevi Patil
Shahab Ahmadzadeh
Sahar Shekoohi
Alan D. Kaye
Publikationsdatum: 01.04.2024
Verlag: Springer US
Erschienen in: Current Pain and Headache Reports
Print ISSN: 1531-3433
Elektronische ISSN: 1534-3081
DOI: https://doi.org/10.1007/s11916-024-01249-z

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

hier abonnieren

Springer Medizin

Assessing Risk Factors and Comorbidities in the Treatment of Chronic Pain: A Narrative Review

Abstract

Purpose of Review

Recent Findings

Summary

Neu im Fachgebiet AINS

Akuter Schwindel: Wann lohnt sich eine MRT?

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Hinter dieser Appendizitis steckte ein Erreger

Ärztliche Empathie hilft gegen Rückenschmerzen

Update AINS

Springer Medizin

Abstract

Purpose of Review

Recent Findings

Summary

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Neu im Fachgebiet AINS

Akuter Schwindel: Wann lohnt sich eine MRT?

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Hinter dieser Appendizitis steckte ein Erreger

Ärztliche Empathie hilft gegen Rückenschmerzen

Update AINS