| Titre : | Prevalence and characteristics of chronic pain among chemically dependent patients in methadone maintenance and residential treatment facilities |
| Titre traduit : | (Prévalence et caractéristiques de la douleur chronique chez des usagers de drogues en traitement de maintenance à la méthadone et en traitement résidentiel.) |
| Auteurs : | A. ROSENBLUM ; H. JOSEPH ; C. FONG ; KIPNIS S. ; C. CLELAND ; PORTENOY R. K. |
| Type de document : | Périodique |
| Année de publication : | 2003 |
| Format : | 23702378 / graph. ; tabl. |
| Note générale : |
JAMA, 2003, 289, (18), 23702378 |
| Langues: | Anglais |
| Discipline : | EPI (Epidémiologie / Epidemiology) |
| Mots-clés : |
Thésaurus mots-clés DOULEUR ; TRAITEMENT DE MAINTENANCE ; TRAITEMENT RESIDENTIEL ; PREVALENCE ; EPIDEMIOLOGIE DESCRIPTIVEThésaurus géographique ETATS-UNIS |
| Résumé : |
ENGLISH : Context: Little is known about the prevalence and characteristics of chronic pain among patients with different types of chemical dependency. Objectives: To estimate the prevalence and to examine the characteristics of chronic severe pain in chemically dependent populations receiving methadone maintenance or inpatient residential treatment. Design, Setting, and Participants: Representative samples of 390 patients from 2 methadone maintenance treatment programs (MMTPs) and 531 patients from 13 short-term residential substance abuse treatment (inpatient) programs, all in New York State, were surveyed in late 2000 and early 2001. Main Outcome Measure: Prevalence of chronic severe pain, defined as pain that persisted for more than 6 months and was of moderate to severe intensity or that significantly interfered with daily activities. Results: Chronic severe pain was experienced by 37% of MMTP patients (95% confidence interval [Cl], 32%-41 %) and 24% of inpatients (95% CI, 20%-28%; P=.03). Pain of any type or duration during the past week was reported by 80% of MMTP patients and 78% of inpatients. Among those with chronic severe pain, 65% of MMTP patients and 48% of inpatients reported high levels of pain-related interference in physical and psychosocial functioning. Among MMTP patients, correlates of chronic pain in a multivariate model were age (odds ratio [OR], 2.08; 95% CI,1.17-3.70), chronic illness (OR,1.88; 95% CI,1.07-3.29), lifetime psychiatric illness (OR,1.77; 95% CI,1.06-2.97), psychiatric distress (OR,1.63; 95% CI,1.22-2.18), and time in treatment (OR, 2.23; 95% CI,1.06-4.68). Among inpatients, the correlates of chronic pain were race (blacks vs whites: OR, 0.52; 95% CI, 0.31-0.90; Hispanics vs whites: OR, 0.48; 95% CI, 0.24-0.95), drug craving (OR, 2.78; 95% CI, 1.54-5.02), chronic illness (OR, 2.17; 95% CI, 1.37-3.43), psychiatric distress (OR, 1.36; 95% CI, 1.03-1.81). Among those with chronic sere pain, inpatients were significantly more likely than MMTP patients to have used illicit drugs, as well as alcohol, to treat their pain complaint (51 % vs 34%, P=.005) but were less likely to have been prescribed pain medications (52% vs 67%, P=.01). Conclusions: Chronic severe pain is prevalent among patients in substance abuse treatment, especially MMTP patients. Pain is associated with functional impairment and correlates of pain vary with the population. Self-medication for pain with psychoactive drugs appears especially problematic among substance users who enroll in drug-free treatment programs. Substance abuse treatment programs need to develop comprehensive and structured pain management programs. (Author' s abstract) |
| Note de contenu : | graph. ; tabl. |
| Domaine : | Drogues illicites / Illicit drugs |
| Refs biblio. : | 32 |
| Affiliation : |
National Development and Research Institutes, 71 W 23rd St, Eighth Floor, New York, NY 10010. Email : rosenblumndri.org Etats-Unis. United States. |
| Numéro Toxibase : | 206858 |
| Centre Emetteur : | 02 Coordonnateur |
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