Predictors of painkiller dependence among people with pain in the general population
AffiliationUniversity of Derby
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AbstractAims: Self-medication with painkillers is widespread and increasing, and evidence about influences on painkiller dependence is needed to inform efforts to prevent and treat problem painkiller use. Design: Online questionnaire survey. Participants: People in the general population who had pain and used painkillers in the last month (n=112). Measurements: Pain frequency and intensity, use of over-the-counter and prescription painkillers, risk of substance abuse (SOAPP scale), depression, anxiety, stress, alexithymia, pain catastrophizing, pain anxiety, pain self-efficacy, pain acceptance, mindfulness, self-compassion, and painkiller dependence (Leeds Dependence Questionnaire). Findings: In multiple regression, the independent predictors of painkiller dependence were prescription painkiller use (ß 0.21), SOAPP score (ß 0.31), and pain acceptance (ß -0.29). Prescription painkiller use mediated the influence of pain intensity. Alexithymia, anxiety and pain acceptance all moderated the influence of pain. Conclusions: The people most at risk of developing painkiller dependence are those who use prescription painkillers more frequently, who have a prior history of substance-related problems more generally, and who are less accepting of pain. Based on these findings, a preliminary model is presented with three types of influence on the development of painkiller dependence: a) pain leading to painkiller use, b) risk factors for substance-related problems irrespective of pain, and c) psychological factors related to pain. The model could guide further research among the general population and high risk groups, and acceptance-based interventions could be adapted and evaluated as methods to prevent and treat painkiller dependence.
CitationElander, J, Duarte, J, Maratos, F, & Gilbert, P (2014), 'Predictors of Painkiller Dependence among People with Pain in the General Population', Pain Medicine, 15, 4, pp. 613-624
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