Day-to-day opioid withdrawal symptoms, psychological distress, and opioid craving in patients with chronic pain prescribed opioid therapy

Bruneau, Alice; Frimerman, Leah; Verner, Maria; Sirois, Alexandra; Fournier, Catherine; Scott, Katherine A.; Pérez, Jordi; Shir, Yoram; Martel, Marc O.

doi:10.1016/j.drugalcdep.2021.108787

Cited by 16 publications

(11 citation statements)

References 85 publications

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“…A more likely mechanism supporting our findings may be psychological relief, particularly anxiety relief and distracting or calming the mind from catastrophizing thoughts, especially if the person has had difficult withdrawal experiences before. For example, in a daily dairy study with chronic pain patients, negative affect and pain catastrophizing mediated the association between withdrawal symptoms and opioid craving [ 44 ]. As acute opioid withdrawal can be a distressing event, more research is needed on these cognitive and affective aspects of withdrawal, as well as non-opioid pharmacological and psychosocial options for withdrawal management.…”

Section: Discussionmentioning

confidence: 99%

“I got a bunch of weed to help me through the withdrawals”: Naturalistic cannabis use reported in online opioid and opioid recovery community discussion forums

et al. 2022

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A growing body of research has reported on the potential opioid-sparing effects of cannabis and cannabinoids, but less is known about specific mechanisms. The present research examines cannabis-related posts in two large online communities on the Reddit platform (“subreddits”) to compare mentions of naturalistic cannabis use by persons self-identifying as actively using opioids versus persons in recovery. We extracted all posts mentioning cannabis-related keywords (e.g., “weed”, “cannabis”, “marijuana”) from December 2015 through August 2019 from an opioid use subreddit and an opioid recovery subreddit. To investigate how cannabis is discussed at-scale, we identified and compared the most frequent phrases in cannabis-related posts in each subreddit using term-frequency-inverse document frequency (TF-IDF) weighting. To contextualize these findings, we also conducted a qualitative content analysis of 200 random posts (100 from each subreddit). Cannabis-related posts were about twice as prevalent in the recovery subreddit (n = 908; 5.4% of 16,791 posts) than in the active opioid use subreddit (n = 4,224; 2.6% of 159,994 posts, p < .001). The most frequent phrases from the recovery subreddit referred to time without using opioids and the possibility of using cannabis as a “treatment.” The most frequent phrases from the opioid subreddit referred to concurrent use of cannabis and opioids. The most common motivations for using cannabis were to manage opioid withdrawal symptoms in the recovery subreddit, often in conjunction with anti-anxiety and GI-distress “comfort meds,” and to enhance the “high” when used in combination with opioids in the opioid subreddit. Despite limitations in generalizability from pseudonymous online posts, this examination of reports of naturalistic cannabis use in relation to opioid use identified withdrawal symptom management as a common motivation. Future research is warranted with more structured assessments that examines the role of cannabis and cannabinoids in addressing both somatic and affective symptoms of opioid withdrawal.

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Section: Discussionmentioning

confidence: 99%

“I got a bunch of weed to help me through the withdrawals”: Naturalistic cannabis use reported in online opioid and opioid recovery community discussion forums

et al. 2022

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“…afraid, upset, nervous, scared, distressed) since their last diary entry on a scale ranging from 1 (not at all) to 5 (extremely). This measure is a diary adaptation of the Positive and Negative Affect Scale (PANAS), 49 which reliability and validity has been supported in several chronic pain studies 60–62 . As in other studies, items were averaged to create a measure of positive affect (PA) and negative affect (NA) score 59–62 …”

Section: Methodsmentioning

confidence: 99%

“…This measure is a diary adaptation of the Positive and Negative Affect Scale (PANAS), 49 which reliability and validity has been supported in several chronic pain studies. [60][61][62] As in other studies, items were averaged to create a measure of positive affect (PA) and negative affect (NA) score. 59-62…”

Section: Positive and Negative Affect Measuresmentioning

confidence: 99%

One session of repetitive transcranial magnetic stimulation induces mild and transient analgesic effects among female individuals with painful temporomandibular disorders

Herrero Babiloni,

Provost,

Charlebois‐Plante

et al. 2024

J of Oral Rehabilitation

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ObjectiveTemporomandibular disorders (TMD) are characterised by chronic pain and dysfunction in the jaw joint and masticatory muscles. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a potential non‐invasive treatment for chronic pain; however, its effectiveness in individuals with TMD has not been thoroughly investigated. This study aimed to evaluate the immediate and sustained (over seven consecutive days) effects of a single session of active rTMS compared to sham stimulation on pain intensity and pain unpleasantness in individuals with TMD.MethodsA randomised, double‐blind, sham‐controlled trial enrolled 41 female participants with chronic TMD. Pain intensity and pain unpleasantness were assessed immediately pre‐ and post‐intervention, as well as twice daily for 21 days using electronic diaries. Secondary outcomes included pain interference, sleep quality, positive and negative affect and pain catastrophizing. Adverse effects were monitored. Repeated measures ANOVA and multilevel modelling regression analyses were employed for data analysis.ResultActive rTMS demonstrated a significant immediate mild reduction in pain intensity and pain unpleasantness compared to sham stimulation. However, these effects were not sustained over the 7‐day post‐intervention period. No significant differences were observed between interventions for pain interference, sleep quality and negative affect. A minority of participants reported minor and transient side effects, including headaches and fatigue.ConclusionA single session of active rTMS was safe and led to immediate mild analgesic effects in individuals with TMD compared to sham stimulation. However, no significant differences were observed between interventions over the 7‐day post‐intervention period. Based on this study, rTMS stimulation appears to be a promising safe approach to be tested in TMD patients with longer stimulation protocols.

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“… 26 – 30 It is also important to assess opioid withdrawal symptoms because they lead to psychological distress and contribute to decreased quality of life. 18 , 31 – 34 In research settings, opioid withdrawal symptoms are commonly assessed in studies testing the effectiveness of pharmacological 26 , 35 , 36 and non-pharmacological 37 – 39 interventions for individuals with OUD.…”

Section: Introductionmentioning

confidence: 99%

“…2,3,[6][7][8] Opioid withdrawal may be experienced with varying intensity and may include signs and symptoms such as tremors, sweating, yawning, piloerection, lacrimation, rhinorrhea, nausea, achiness, restlessness and dysphoria. 2,3,[6][7][8] Opioid withdrawal symptoms are mainly observed among illicit opioid users presenting with opioid use disorder (OUD), [7][8][9][10][11] but transient opioid withdrawal symptoms may also be experienced towards the end of dosing intervals among patients prescribed daily opioid therapy, 2,[12][13][14][15][16][17][18] or when patients undergo opioid dose reduction. [19][20][21][22][23] The assessment of opioid withdrawal symptoms is common in both clinical and research settings.…”

Section: Introductionmentioning

confidence: 99%

French-Canadian Translation and Cultural Adaptation of the Clinical Opiate Withdrawal Scale: The COWS-FC

et al. 2022

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The assessment of opioid withdrawal symptoms is common in both clinical and research settings. The Clinical Opiate Withdrawal Scale (COWS) is among the most frequently used instruments for the assessment of signs and symptoms associated with opioid withdrawal. The COWS is a validated, clinician-administered instrument initially developed and validated for English-speaking populations. To date, however, the COWS has yet to be linguistically and culturally adapted for French-Canadian populations. Objective The main objective of the present study was to develop a French-Canadian translation and adaptation of the COWS (i.e., the COWS-FC) for the assessment of opioid withdrawal symptoms in clinical and research settings. Methods The French-Canadian translation and cultural adaptation of the COWS was performed following guidelines for the translation and cross-cultural adaptation of self-report measures. The steps consisted of (1) initial translation from English to French, (2) synthesis of the translation, (3) back-translation from French to English, (4) expert committee meeting, (5) test of the prefinal version among healthcare professionals and (6) review of final version by the expert committee. The expert committee considered four major areas where the French-Canadian version should achieve equivalence with the original English-version of the COWS. These areas were (1) semantic equivalence; (2) idiomatic equivalence; (3) experiential equivalence and (4) conceptual equivalence. Results Rigorous steps based on the guidelines for the translation and cultural adaptation of assessment tools were followed, which led to a semantically equivalent version of the COWS. After a pretest among healthcare professionals, members from the expert committee agreed upon slight modifications to the French-Canadian version of the COWS to yield a final COWS-FC version. Conclusions A French-Canadian translation and adaptation of the COWS (i.e., the COWS-FC) was developed. The COWS-FC could be used for the assessment of opioid withdrawal symptoms in clinical and research settings.

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Day-to-day opioid withdrawal symptoms, psychological distress, and opioid craving in patients with chronic pain prescribed opioid therapy

Cited by 16 publications

References 85 publications

“I got a bunch of weed to help me through the withdrawals”: Naturalistic cannabis use reported in online opioid and opioid recovery community discussion forums

“I got a bunch of weed to help me through the withdrawals”: Naturalistic cannabis use reported in online opioid and opioid recovery community discussion forums

One session of repetitive transcranial magnetic stimulation induces mild and transient analgesic effects among female individuals with painful temporomandibular disorders

French-Canadian Translation and Cultural Adaptation of the Clinical Opiate Withdrawal Scale: The COWS-FC

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