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The Connection Between Chronic Pain, Mental Illness and Addiction

Author: Shernide Delva

Chronic pain can be extremely difficult to manage. Pain management involves a variety of treatment options, but one area that desperately needs attention is the psychological impact of chronic pain. According to researchers, about half of adults with chronic pain also experience anxiety or mood disorders like depression.

The findings, published online in the Journal of Affective Disorders, highlight the need to offer treatment and resources to those struggling with the psychological impact of chronic pain.

“The dual burden of chronic physical conditions and mood and anxiety disorders is a significant and growing problem,” said Silvia Martins, MD, Ph.D., associate professor of Epidemiology at the Mailman School of Public Health, and senior author.

The research examined data to analyze the associations between mood and anxiety disorder and self-reported chronic physical conditions. 5,037 participants in São Paulo, Brazil participated in the interview process.

Among individuals with mood disorders, chronic pain was reported by 50 percent, followed by respiratory disease at 33 percent, cardiovascular disease at 10 percent, arthritis by 9 percent, and diabetes by 7 percent.

Anxiety disorders were also common among those with chronic pain reported at 45 percent, and respiratory at 30 percent, as well as arthritis and cardiovascular disease, each 11 percent.

“These results shed new light on the public health impact of the dual burden of physical and mental illness,” said Dr. Martins. “Chronic disease coupled with a psychiatric disorder is a pressing issue that health providers should consider when designing preventive interventions and treatment services — especially the heavy mental health burden experienced by those with two or more chronic diseases.”

Chronic Pain and Painkiller Addiction

One common treatment for chronic pain is the use of prescription painkillers. Opioids like Vicodin, OxyContin, and Percocet affect specific parts of the brain that reduce the perception of pain. However, along with reducing the perception of pain, these medications also release feel-good chemicals in the brain, often leading to dependence.

With this study, it is clear why chronic pain sufferers are susceptible to opioid dependence due to a variety of factors including the need for feel-good chemicals like dopamine. Chemicals like dopamine and serotonin are lacking in those with depression and anxiety.

Many patients who take prescription painkillers do so without forming any dependence.  In some, opioid use generates negative side effects such as nausea, making them more unwilling to use the drug’s long-term. Still, some individuals are so desperate for pain relief, that they take larger doses than prescribed more frequently. Not long after, a full-blown addiction develops.

It is important to note that there is no way to know whether a prescription painkiller user will develop an addiction to opioids. However, factors like having a family history of addiction, struggling with mood disorders such as depression or anxiety, or experiencing a past trauma, such as physical or sexual abuse all increase the risk. Those who have struggled with previous addiction are at a higher risk as well.

Another dangerous aspect of opioid addiction is that it often leads to heroin use. Health officials confirm that this is not uncommon. Because painkillers are more difficult to obtain and more expensive, many users turn to using heroin. Heroin is in a similar drug classification as opioids and is easy to obtain for cheap on the street.

Overall, this study says a lot about the way mental disorders and addiction often go hand in hand. That’s why so many treatment centers offer a dual diagnosis program. Therefore, if you struggle with mental illness, addiction or both, please call now. We want to help.

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