Pain Acceptance Creates an Emotional Context That Protects against the Misuse of Prescription Opioids: A Study in a Sample of Patients with Chronic Noncancer Pain

Abstract

There is solid evidence of an association between several psychological flexibility processes, particularly pain acceptance, and adaptation to chronic pain. However, there are relatively few studies on the relationship between pain acceptance and opioid misuse in chronic pain patients. Thus, the aim of the present study was to test a hypothetical model in which pain acceptance would regulate pain sensations and pain-related thoughts and emotions, which would be related to opioid misuse. The sample comprised 140 chronic pain patients attending two hospitals. All patients were receiving pharmacological treatment, including opioid analgesics. Structural equation modelling analyses showed a significant association between higher pain acceptance and lower pain intensity and catastrophizing, and lower levels of anxiety and depression. Only higher anxiety and depression were significantly associated with increased opioid misuse. The results suggest that levels of anxiety, depression, and pain acceptance must be assessed before opioids are prescribed. Pain acceptance implies a relationship with internal events that protects against anxiety and depression and thus against opioid misuse. Acceptance and Commitment Therapy appears to be particularly appropriate for these patients.

Associations Between Six Core Processes of Psychological Flexibility and Functioning for Chronic Pain Patients: A Three-Level Meta-Analysis

“…Furthermore, individuals in a state of psychological distress experience more intense pain, leading to a reciprocal reinforcement between psychological distress and pain ( 5 , 6 ). Chronic pain also costs economically higher than other diseases ( 4 ), leading to immense suffering for their families and high costs on our communities and healthcare systems ( 7 ).…”

“…Chronic pain is one of the most common physical problems all over the world in the general population (1)(2)(3) and is a source of distress and disability that affects all aspects of a patient's life (4,5). Furthermore, individuals in a state of psychological distress experience more intense pain, leading to a reciprocal reinforcement between psychological distress and pain (5,6).…”

Therapeutic itinerary of patients with chronic low-back pain attending outpatient physiotherapy clinic

“…Outra literatura sugere que a dor interrompe não apenas a atenção, mas também a vida diária. Foi demonstrado que fatores psicológicos e sociais predizem resultados e comportamentos de indivíduos com dor crônica e, portanto, influenciam também a automedicação (17) .…”

“…A dor lombar tem um impacto significativo na capacidade funcional, pois restringe as atividades ocupacionais, sendo uma das principais causas de absenteísmo (7) . Além disso, relatou-se que a saúde psicossocial dos pacientes deste estudo foi afetada, em consonância com estudos anteriores (13,17) . Também em concordância com estudos anteriores, os pacientes neste estudo relataram que a dor lombar tem efeito em sua família.…”

Influence of Stabilization Techniques Used in the Treatment of Low Back Pain on the Level of Kinesiophobia

“…Even in currently healthy people, the risk of further ailments increases, which leads to the chronicity of the phenomenon [ 13 ]. It has been proven that people suffering from chronic lower back pain avoid risky situations, and if they decide to engage in any activity, it is performed with a very high level of caution, which directly affects the quality of a given motor task [ 14 ]. Such conduct will affect the dysfunction of the lumbar muscles, which may potentially lead to even greater limitations in physical activity and an increase in pain sensations [ 15 ].…”