Prescription opioid abuse, addiction and psychopathology in a pain clinic

Introduction There has been an escalation of therapeutic use and abuse of opioids. Aberrant drug related behaviors (ADRB) have prevalence between 2.8% and 62.2% in chronic pain patients treated with opioids and dependence is estimated around 3.27%. Objectives To estimate the prevalence of dependence, ADRB, risk of opioid abuse, and co-occurring disorders in patients with chronic pain in our environment. Methods A total of 115 ( n  = 115) patients attending our pain clinic were screened to evaluate the risk of opioid abuse and presence of dependence including a clinical interview, hamilton depression scale (HAD), opioid risk tool (ORT), diagnostic criteria for substance abuse and dependence (DSM IV-TR) and a checklist of ADRB. Results Among the patients, 78.26% were taking opioids, aberrant opioid related behaviors were detected in 20% and 8.9% met criteria for abuse or dependence; 11.3% had high risk and 20% moderate risk of opioid abuse (ORT). The most prevalent substance use disorders were sedative (11.3%) and alcohol (5.2%). There was a significant difference in means ( t  = -3.20 P  10 on anxiety and depression respectively on the HAD. Conclusions A systematic screening of risk of opioid abuse and of dependence as well as psychotherapy to treat comorbid psychopathology should be part of the treatment protocol.