EPA-1277 – Opioids: the enemy or the ally?

Introduction Chronic pain is a prevalent condition worldwide. Opioids have beneficial effects when treating pain, but also involve risks. Opioid iatrogenic dependence(OID) is becoming more prevalent in western countries. Co-occurring psychiatric disorders are both among its predisposing factors and its complications. Objectives To review factors predicting response to opioid treatment, especially those related with psychiatric comorbidities. We describe a case of OID as an example of the patient-type. Aims Attention needs to be paid to OID considering its growing health impact. Materials/Methods Throughout the case of a patient with chronic pain due to post-radiotherapic proctalgia, who suffered from depression and showed maladaptive personality traits, we describe a case of OID. Results All patients assisted at our Pain Clinic have current or previous psychiatric disorders, and in almost half of the cases is major depression, as it happens in our case-example. Concomitant psychopharmacological treatment of opioid dependence and psychiatric comorbidities (including other drugs abuse/dependence) improves outcomes. Conclusions A global view of the opioid-consumer that includes comorbid psychiatric conditions is needed.