Chronic Pain and Hepatitis C Virus Infection in Opioid Dependent Injection Drug Users

Abstract

It is unknown if infection with hepatitis C virus (HCV) is a risk factor for pain among persons who have used injection drugs (IDU). Multivariate regression was used to determine whether HCV was associated with greater likelihood of reporting significant chronic pain and discomfort intolerance in a cohort of 97 opioid dependent IDU. Study results suggest that participants with HCV may be more likely to suffer chronic pain (aOR=1.98; 95% CI: 0.76 to 5.12, p=0.16). Furthermore, HCV was found to be associated with a higher discomfort intolerance scale score, reflecting intolerance to physical discomfort (β=2.34; 95% CI: 0.06 to 4.62, p=0.04). Infection with HCV may be an overlooked cause for chronic pain and discomfort intolerance among opioid dependent IDU.

Pain Symptoms Associated with Opioid Use among Vulnerable Persons with HIV: An Exploratory Study with Implications for Palliative Care and Opioid Abuse Prevention

“…Inadequate pain management may affect drug or alcohol use or relapse, especially among persons with serious chronic illness and a history of drug abuse. Injection drug using persons often use opioids and report high levels of pain, which may in part be explained by their high rates of human immunodeficiency virus (HIV) 1,2 and other pain-related conditions 3,4 . African Americans comprise the vast majority of HIV seropositive, injection drug using persons and experience disparities in pain symptoms and management 5,6,7 .…”

Hepatitis C virus infection and pain sensitivity in patients on methadone or buprenorphine maintenance therapy for opioid use disorders

“…In a prior study of persons with opioid use disorders seeking treatment with buprenorphine, it was observed that patients with HCV were more likely to report intolerance to physical discomfort (Tsui et al, 2011). The fact that all our participants were maintained on OAT could contribute to our findings, as it is possible that opioid-related hyperalgesia might overwhelm any differences caused by HCV.…”

“…A high prevalence of chronic pain has been observed among HCV-infected veterans (Silberbogen et al, 2007; Whitehead et al, 2008) and HCV was associated with pain among HIV-infected persons, even after adjustment for psychiatric co-morbidities and socio-demographics (Tsui et al, 2012). A study of persons with opioid use disorders seeking treatment with buprenorphine found that patients with HCV were more likely to report intolerance to physical discomfort (Tsui et al, 2011). Prior studies of experimental pain tolerance comparing participants on methadone and buprenorphine to controls have not explored the contributions of HCV even though this infection is highly prevalent in the OAT treated population.…”

Clinical Comorbidities among Cocaine Users Screened in the Community through HealthStreet

“…4 Some of the most frequent complications associated with cocaine use are cardiovascular (acute coronary syndrome, cardiac arrhythmias, increased blood pressure); respiratory (fibrosis, interstitial pneumonitis, pulmonary hypertension, alveolar hemorrhage, asthma exacerbation, emphysema); neurological (strokes, aneurysms, seizures, headaches); and communicable diseases such as HIV/AIDS, hepatitis B and C, and sexual transmitted diseases (STDs). 5,6 However, the association of musculoskeletal (MSK) complications including any kind of arthritis and back pain with cocaine use rarely have been studied and reported. Furthermore, many health conditions that are increased among cocaine users may result in joint pain, including hepatitis C virus (HCV) and HIV infections.…”

“…Whereas HCV is common in cocaine users and has been linked to MSK conditions (peripheral neuropathies, arthritis, etc), support for this association has been limited by a lack of controls and/or adjustment for important confounders, most notably substance abuse. 6 In the current study using data from a community engagement program in 3 geographic areas throughout the United States, we investigated the differences in clinical characteristics in general and MSK conditions in particular by cocaine versus non-cocaine use to understand the clinical risk factors among cocaine users. In addition, as a secondary objective, we also did a sensitivity analysis looking at racial differences by MSK.…”