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1.
East Mediterr Health J ; 26(2): 212-218, 2020 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-32141600

RESUMO

Background: Parenting approach and early childhood experiences are thought to be two important factors in the initiation of substance use. Aims: We aimed to explore the nurse's role in the prevention of childhood addiction. Methods: In this qualitative study we conducted in-depth interviews with young men and women who were either in treatment for their addiction or were active drug users as well as with family members and nurses. The data analysis followed Strauss and Corbin's constant comparison method. Results: The data analysis revealed six categories: traumatic events during childhood, inappropriate parenting approach, Lack of knowledge and a tolerant attitude toward drug use, turning a blind eye on the threat of drug use, nurses' poor experience of drug use prevention, and the lack of a clear definition of the nurse's role in prevention of drug use. Conclusions: Nurses who work with young people and their families have a special opportunity for prevention, early detection and timely intervention for drug dependency.


Assuntos
Usuários de Drogas/psicologia , Papel do Profissional de Enfermagem , Transtornos Relacionados ao Uso de Substâncias/enfermagem , Adolescente , Adulto , Comportamento Aditivo/enfermagem , Comportamento Aditivo/prevenção & controle , Comportamento Aditivo/psicologia , Criança , Feminino , Humanos , Acontecimentos que Mudam a Vida , Masculino , Pesquisa Qualitativa , Estresse Psicológico/psicologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/psicologia
2.
Medicine (Baltimore) ; 99(10): e19124, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32150053

RESUMO

Many smartphone users experience pain in the thumb/wrist. This pain can be due to certain types of hand injuries as well as inflammation of the extensor pollicis brevis and the abductor pollicis longus tendon sheaths, known as De Quervain tenosynovitis. The objective of this study was to evaluate the association between smartphone addiction and wrist/thumb pain and to determine the severity of the pain, as well as to calculate the prevalence of De Quervain tenosynovitis among medical students at King Abdulaziz University (KAU) in Jeddah.A total of 387 medical students were enrolled. The smartphone addiction scale-short version (SAS-SV) was used to divide participants into the smartphone addict group and non-addict group. Both groups completed the self-administered patient-rated wrist and hand evaluation (PRWHE) questionnaire to evaluate wrist/hand pain. The Finkelstein test was administered to those who reported pain in the thumb/wrist.Two hundred fifty-seven (66.4%) participants were smartphone addicts; 74 (19.1%) had a positive Finkelstein test. There was a significant correlation between smartphone addiction and high PRWHE scores (P = .036).Our study found the prevalence of smartphones addiction among university students to be high (66%), furthermore a correlation between heavy smartphones usage and hand pain was found which indicates that heavy usage of these devices can cause subclinical effects on the human hand.


Assuntos
Comportamento Aditivo/epidemiologia , Comportamento Aditivo/fisiopatologia , Dor/etiologia , Smartphone , Polegar/fisiopatologia , Punho/fisiopatologia , Estudos Transversais , Doença de De Quervain/epidemiologia , Doença de De Quervain/etiologia , Humanos , Dor/epidemiologia , Medição da Dor , Prevalência , Arábia Saudita/epidemiologia , Estudantes de Medicina
3.
Rev Med Suisse ; 16(676-7): 8-11, 2020 Jan 15.
Artigo em Francês | MEDLINE | ID: mdl-31961074

RESUMO

This article describes a new form of administration of inhaled prescribed heroin currently under investigation. It underlines the particularity of opioid agonist prescription in jail and presents new perspectives in using psilocybin in addiction medicine treatment. A brief literature review about vaping confirms its interest in quitting cigarette, with a cost of addiction to vaping and recent worrisome reports of chemical pneumonia. Finally, the withdrawal of WHO guidelines on opiates use in pain management, in the context of a suspicion of conflict of interest, underlines the sensible balance between over- and under- prescription of opiates in analgesic treatment.


Assuntos
Comportamento Aditivo , Transtornos Relacionados ao Uso de Opioides , Analgésicos Opioides , Humanos , Manejo da Dor
4.
Nervenarzt ; 91(1): 77-90, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31919549

RESUMO

Despite their knowledge about the risks and treatment options for substance abuse disorders, physicians are not immune to them. Meanwhile, a number of studies have shown that physicians have an increased risk of depression, addictive diseases and burnout due to the occupation-linked mental and physical burden and in particular an increased prevalence of substance-related disorders, especially alcohol abuse or dependence and drug abuse. Drug dependence among physicians seems to be even higher than in the general population due to the relatively easy access to psychoactive medications, in particular hypnotic drugs, benzodiazepines, ketamine and opioids; however, the prognosis is good. According to data from the medical associations, three quarters of those affected for the first time and every sixth relapsed physician can be helped with preservation of the license and working as physicians.


Assuntos
Alcoolismo , Comportamento Aditivo , Médicos , Transtornos Relacionados ao Uso de Substâncias , Benzodiazepinas , Humanos , Médicos/psicologia , Prevalência
5.
Expert Opin Pharmacother ; 21(3): 287-296, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31928246

RESUMO

Introduction: Gambling disorder is classified as an addictive disorder and is associated with significant distress and impairment in personal, social, occupational or other important areas of functioning. Although no pharmacotherapy has a formal indication for gambling disorder, data suggest potential benefits of specific medications.Area covered: This systematic review evaluated findings from 19 randomized controlled trials testing pharmacotherapies for the treatment of gambling disorder.Expert opinion: Few randomized controlled trials have studied pharmacotherapies for gambling disorder. Though results are limited, opioid antagonists like naltrexone showed promise in the pharmacological treatment of gambling disorder. Pharmacotherapy combined with psychotherapy treatments for gambling disorder may provide better rates of patient retention in comparison to pharmacology-only treatments, though further research is needed in this area. Future studies should address gaps relating to considerations of racial, ethnic, gender and other individual differences in clinical studies. Because gambling disorder often co-occurs with other psychiatric disorders, additional research is needed to test treatments for dually diagnosed patients.


Assuntos
Comportamento Aditivo/tratamento farmacológico , Jogo de Azar/tratamento farmacológico , Diagnóstico Duplo (Psiquiatria) , Humanos , Naltrexona/uso terapêutico , Antagonistas de Entorpecentes/uso terapêutico , Psicoterapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico
6.
Medicine (Baltimore) ; 99(4): e18456, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31977844

RESUMO

BACKGROUND: In this study, we aim to assess the psychological effects of cognitive behavioral therapy (CBT) on internet addiction (IA) in adolescents. METHODS: This study will search the following databases of Cochrane Library, PUBMED, EMBASE, Scopus, Web of Science, PsycINFO, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. All these electronic databases will be searched from inception to the September 30, 2019 without any language limitation. Two authors will conduct study selection, data extraction, and study quality assessment, respectively. Any disagreements between 2 authors will be solved by a third author through discussion. Statistical analysis will be performed using RevMan 5.3 software. RESULTS: This study will investigate the psychological effects of CBT on IA in adolescents by measuring psychopathological symptoms, depression, anxiety, time spent on the internet (hours/day), and health-related quality of life. CONCLUSION: This study summarizes current evidence of CBT on IA in adolescents and may provide guidance for both intervention and future researches.PROSPERO registration number: PROSPERO CRD42019153290.


Assuntos
Comportamento Aditivo/terapia , Terapia Cognitivo-Comportamental/métodos , Internet , Adolescente , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa
7.
Z Kinder Jugendpsychiatr Psychother ; 48(1): 3-14, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31094644

RESUMO

Effectiveness of an early intervention program for adolescents with Internet Gaming and Internet Use Disorder: Medium-term effects of the PROTECT+ Study Abstract. Objective: Internet Gaming and Internet Use Disorder (IGD and IUD) have gained increasing attention in the scientific community over the last few years. The inclusion of "Gaming Disorder" in the ICD-11 (International Statistical Classification of Diseases and Related Health Problems) promoted the need for evidence-based and effective treatments. PROTECT+ is such a cognitive-behavioral group therapy program for adolescents with IGD and IUD. The present study evaluates the medium-term effects after 4 months. Method: N = 54 patients, aged 9 to 19 years (M = 13.48, SD = 1.72), participated in the early intervention study between April 2016 and December 2017 in Heidelberg, Germany. Symptom severity was assessed at baseline, at the end of the treatment, and at 4-month follow-up using standardized diagnostic tools. Results: Multilevel analyses showed a significant reduction in symptom severity using the Video Game Dependency Scale (CSAS) at 4-month follow-up. We found a small effect size in self-reported reduction of symptom severity (d = 0.35) and a moderate effect size in parental ratings (d = 0.77). The Reliable Change Index measured by the Compulsive Internet Use Scale (CIUS) indicated a high heterogeneity in individual symptom changes over time. Patients showed high satisfaction regarding the treatment program at 1- und 4-month follow-up. Conclusions: This study is internationally one of the few to show a significant reduction of IGD and IUD symptoms after 4 months.


Assuntos
Comportamento Aditivo , Intervenção Médica Precoce , Internet , Jogos de Vídeo/psicologia , Adolescente , Comportamento do Adolescente , Criança , Alemanha , Humanos , Adulto Jovem
8.
Psychiatr Hung ; 35(1): 73-80, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31854325

RESUMO

BACKGROUND AND AIMS: Parental bonding is regarded as one of the risk factors of problematic internet use among adolescents and young adults; however, only few studies have examined the association between problematic social media use and parental bonding among adolescents. The aim of this study is to investigate the difference between problematic internet use and problematic social media use in terms of their associations with parental bonding among secondary school students. METHOD: With a cross-sectional design and convenience sampling, 2035 self-reported questionnaires were collected in a paper-pencil survey (54.2% females, mean age=16.97, SD=1.61). Problematic internet use, problematic social media use and parental bonding with both mother and father were measured. The predictors of problematic internet use and social media use were tested simultaneously with structural equation modeling. RESULTS: Problematic internet use and social media use correlate significantly (r=0.57). Girls reported more symptoms in problematic use of internet and social media. Maternal and paternal overprotection were significantly associated with problematic social media use. Paternal care decreased and maternal overprotection significantly increased the problematic internet use. However, the model only explains a small part of the variance of both types of problematic use (10% and 7%, respectively). CONCLUSION: Parental overprotection may be a small but significant risk factor for developing problematic internet uses. Problematic internet use and problematic social media use are not the same; they are slightly different in their associations with parental bonding dimensions.


Assuntos
Comportamento Aditivo , Internet , Relações Pais-Filho , Mídias Sociais , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Autorrelato , Inquéritos e Questionários
10.
J Opioid Manag ; 15(6): 487-494, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31850510

RESUMO

OBJECTIVE: To characterize hedonic eating behaviors such as sugar cravings, food preferences, and appetitive responsiveness for sweet and hyper-palatable foods, and to determine the prevalence of addictive like eating behaviors and food addiction (FA) in individuals receiving medication-assisted treatment (MAT) for opioid use disorder (OUD). DESIGN: Quasi-experimental. SETTING: Outpatient MAT center. PARTICIPANTS: Nonpregnant adult patients undergoing MAT (n = 116) receiving either buprenorphine/naloxone or methadone for at least 6 months. MAIN OUTCOME MEASURES: Hedonic eating, FA, and food craving. RESULTS: Of the aggregate sample, 13.3 percent met criteria for FA. More than onethird of all subjects endorsed consuming larger amounts of highly palatable food than intended, unsuccessful attempts to quit or cut down on eating such foods, and a great deal of time spent on consuming or recovering from consuming such foods. Both medication groups demonstrated greatest cravings for sweets and fast foods followed by carbohydrates and fats (p < 0.001). Similarly, subjects reported "giving in" most frequently to sweets and fast foods followed by carbohydrates then fats (p < 0.001). Greater appetitive responsiveness was noted in the presence of hyper-palatable foods. No group differences were found. Weight change was not associated with addictive like eating, food craving, or appetitive responsiveness. CONCLUSIONS: Individuals receiving MAT exhibit preferences for sweet and fast foods that appear to be influenced by the proximity of such foods. FA was present. Collectively, such eating behaviors and food preferences may pose additional adverse health consequences and associated co-morbidities. This underlies the importance of comprehensive healthcare for patients with OUD, including nutrition education and evaluation of eating behaviors and food preferences.


Assuntos
Comportamento Aditivo/epidemiologia , Comportamento Alimentar , Preferências Alimentares , Transtornos Relacionados ao Uso de Opioides , Adulto , Analgésicos Opioides , Comportamento Aditivo/psicologia , Fissura , Gorduras na Dieta , Ingestão de Alimentos , Fast Foods , Comportamento Alimentar/psicologia , Humanos , Transtornos Relacionados ao Uso de Opioides/complicações , Transtornos Relacionados ao Uso de Opioides/terapia
11.
Arch. argent. pediatr ; 117(6): 584-591, dic. 2019. tab
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1046377

RESUMO

Introducción: el avance de la tecnología e internet aumentaron la frecuencia con que los niños utilizan videojuegos. El objetivo fue determinar la frecuencia y patrones de uso y la adicción a videojuegos (AVJ) en alumnos de secundaria y la relación con factores sociodemográficos, familiares e individuales. Población y métodos: estudio descriptivo transversal en cuatro escuelas secundarias. Se realizó un cuestionario estructurado a los padres y la "Videogame Addiction Scale for Children (VASC)" a los alumnos jugadores de videojuegos. Resultados: se incluyó a 297 alumnos; 245 (82,5 %) jugaban a videojuegos. La tasa total de AVJ fue 1,6 % en toda la muestra. La tasa de AVJ fue 3,1 % entre los varones. La media geométrica para VASC (MG-VASC) fue mayor en varones y alumnos obesos (p < 0,001, p = 0,022, respectivamente). Los alumnos que utilizan redes sociales tuvieron puntajes más altos (p = 0,034). Las consolas, los juegos en línea y multijugador aumentan los puntajes de la MG-VASC (p = 0,028, p = 0,002, p = 0,016, respectivamente). Los juegos de guerra y estrategia tenían MG-VASC más elevadas (p < 0,001, p = 0,034, respectivamente). Los juegos de ingenio y casuales se relacionaron con puntajes menores (p = 0,006, p = 0,004, respectivamente).Conclusiones. Ser varón, ser obeso, usar redes sociales, tener consola, jugar a géneros específicos (guerra o estrategia), y los juegos en línea y multijugador están relacionados a mayores puntajes de la VASC en alumnos de secundaria. Los estudios prospectivos y las medidas preventivas deberían centrarse en esto.


Introduction: The rapid progress of technology and widespread use of internet has increased thefrequency of video gaming among children. The objective was to determine the frequency and patterns of video game use and video game addiction (VGA) in secondary school students and the relationship with socio-demographic, familial and individual factors. Population and methods: This cross-sectional descriptive study was conducted in four secondary schools in varied sociodemographic characteristics. A structured questionnaire was applied to the parents who agreed to participate. 'Videogame Addiction Scale for Children (VASC)' was performed to the video-gamer students. Results: 297 healthy students were included; 245 (82.5 %) reported as video game players. The rate of VGA was 1.6 % in our whole sample. The VGA rate was 3.1 % within the male students. VASC-Geometric Mean Score (VASC-GMS) was significantly higher in male and obese children (p < 0.001, p= 0.022, respectively). Students who use socialmedia also had higher scores (p= 0.034). Gaming consoles, online games or games with multiplayers increase the VASC-GMS scores (p= 0.028, p= 0.002, p= 0.016, respectively). War and strategy games lead higher VASC-GMS (p < 0.001, p= 0.034, respectively). In contrast, mind and casual games were related to lower VASC-GMS (p= 0.006, p= 0.004, respectively).Conclusions. It was observed that being male, being obese, use of social media, game console ownership, playing specific game genres (war or strategy games), online and multiplayer games are related to higher scores of video game addiction scale in secondary school students. Future prospective studies and preventive measures on VGA should focus on these factors.


Assuntos
Humanos , Adolescente , Comportamento Aditivo , Jogos de Vídeo/efeitos adversos , Estudantes , Epidemiologia Descritiva , Estudos Transversais , Obesidade
12.
Int Health ; 11(S1): S33-S44, 2019 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-31670820

RESUMO

BACKGROUND: With the popularization of smartphones in China, the conditions of smartphone use (SU) and problematic smartphone use (PSU) among migrant workers are unknown. This study explored the patterns and influencing factors of SU and PSU in migrant workers in Shanghai, China. Furthermore, the mediation effects of PSU in the link between SU and some psychological factors were also examined. METHODS: Questionnaires containing the Mobile Phone Addiction Index, Patient Health Questionnaire, World Health Organization Five-item Well-being Index and other items, including demographics, sleep quality, job stress and SU, were distributed to 2330 migrant workers by trained investigators in six districts of Shanghai from June to September 2018. RESULTS: Of the 2129 returned questionnaires, 2115 were valid. SU and PSU varied according to certain demographics. Many demographics, psychological factors, sleep quality and main smartphone applications were influencing factors for SU and PSU. PSU played a mediating role in the link between daily SU time and psychological factors, including depression, mental health and job stress. CONCLUSIONS: The health influences of SU and PSU on migrant workers in Shanghai merit significant attention. Additionally, it is necessary to develop and target intervention strategies according to the workers' various characteristics and SU patterns.


Assuntos
Comportamento Aditivo/epidemiologia , Saúde Mental/estatística & dados numéricos , Smartphone/estatística & dados numéricos , Migrantes/psicologia , Migrantes/estatística & dados numéricos , Adulto , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
14.
Presse Med ; 48(12): 1551-1568, 2019 Dec.
Artigo em Francês | MEDLINE | ID: mdl-31767247

RESUMO

CONTEXT: Gambling and gaming disorders have been introduced as addictions in the DSM-5 and have been announced for the next edition of the ICD. Links between gambling and gaming and psychiatric comorbidities have been thoroughly investigated, but so far the impact of gambling and gaming on physical health has been overlooked. OBJECTIVE: Our aim was to evaluate the impact of gaming and gambling disorders on the physical health of gamers and gamblers. SOURCES: We conducted a systematic review of the literature, using PubMed/Medline to retrieve studies with the following: keywords: "gambling" ; "pathological gambling" ; "gambling health" ; "gaming" ; "pathological gaming" and "gaming health". PAPERS SELECTION: Selected studies all reported on the physical health of gamers and gamblers with addiction. We obtained 133 articles from the Medline database. After screening abstracts and introductions and full reading of papers we retrieved 25 articles for this review. Seventeen articles reporting 56,179 subjects with gambling disorder and 8 articles reporting 63,887 subjects with gaming disorder. RESULTS: All papers described the physical health of individuals with gaming and gambling disorders. For gambling, data showed the existence of digestive disorder (20 to 40%), sleeping disorders (35 to 68%), headaches (20 to 30%) and cardiovascular disorders: tachycardia (9%) and coronary artery disease (2 to 23%). Results were mostly significant when compared to the general population. For gaming, available studies reported qualitative data. Most frequently reported symptoms were sleeping complaints, joint pain, headaches and visual problems. These symptoms were more frequently described for teenagers. Sleeping complaints were the most frequently reported symptom. LIMITS: Although we found that the physical health of gamers and gamblers with addiction was impaired, no study investigated the causal role of addiction, gaming, and gambling. Further studies are needed to better understand how behavioral addictions impact physical heath. CONCLUSION: Data reported in this review documented that individuals with gaming or gambling disorders have an impaired physical health. Knowledge of the symptoms reported could help primary care physicians to better screen for gambling and gaming disorders among their patients.


Assuntos
Jogo de Azar/fisiopatologia , Nível de Saúde , Jogos de Vídeo/efeitos adversos , Comportamento Aditivo/complicações , Comportamento Aditivo/epidemiologia , Comportamento Aditivo/fisiopatologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtornos Disruptivos, de Controle do Impulso e da Conduta/diagnóstico , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/etiologia , Jogo de Azar/complicações , Jogo de Azar/epidemiologia , Humanos , Jogos de Vídeo/psicologia , Jogos de Vídeo/estatística & dados numéricos
18.
Adv Exp Med Biol ; 1192: 53-93, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31705490

RESUMO

Psychiatric disorders such as addiction (substance use and addictive disorders), depression, eating disorders, schizophrenia, and post-traumatic stress disorder (PTSD) are severe, complex, multifactorial mental disorders that carry a high social impact, enormous public health costs, and various comorbidities as well as premature morbidity. Their neurobiological foundation is still not clear. Therefore, it is difficult to uncover new set of genes and possible genetic markers of these disorders since the understanding of the molecular imbalance leading to these disorders is not complete. The integrative approach is needed which will combine genomics and epigenomics; evaluate epigenetic influence on genes and their influence on neuropeptides, neurotransmitters, and hormones; examine gene × gene and gene × environment interplay; and identify abnormalities contributing to development of these disorders. Therefore, novel genetic approaches based on systems biology focused on improvement of the identification of the biological underpinnings might offer genetic markers of addiction, depression, eating disorders, schizophrenia, and PTSD. These markers might be used for early prediction, detection of the risk to develop these disorders, novel subtypes of the diseases and tailored, personalized approach to therapy.


Assuntos
Comportamento Aditivo/genética , Depressão/genética , Transtornos da Alimentação e da Ingestão de Alimentos/genética , Esquizofrenia/genética , Transtornos de Estresse Pós-Traumáticos/genética , Transtornos Relacionados ao Uso de Substâncias/genética , Marcadores Genéticos , Humanos , Psiquiatria
19.
Adv Exp Med Biol ; 1192: 263-279, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31705499

RESUMO

This article gives an overview of the concept and brain mechanisms of Internet game and smartphone addiction and the applicability of precision medicine and smart healthcare system. Internet game and smartphone addiction are categorized as behavioral addictions, which share similar phenomenology and neurobiological underpinnings with substance addictions. Neuroimaging studies revealed the alteration in the functional activity and structure of individuals with Internet game and smartphone addiction, which also can be potent biomarkers. Precision medicine is defined as treatments targeted to the individual patients on the basis of genetic, biomarker, phenotypic or psychosocial characteristics. Recent advances in high-throughput technology and bioinformatics have enabled us to integrate these big data with behavioral data collected from smartphones or other wearable devices. Data collected via smart devices can be transferred to medical institute and integrated in order to diagnose current status precisely and to provide optimal intervention. The feedbacks of intervention are sent back to the medical provider via self-reports or objective measures to evaluate the appropriateness of the intervention. In conclusion, Internet game and smartphone addiction can be diagnosed precisely using high-throughput technology and optimally managed via smart healthcare system.


Assuntos
Comportamento Aditivo/diagnóstico , Terapia Cognitivo-Comportamental/métodos , Assistência à Saúde/métodos , Internet , Transtornos Mentais/epidemiologia , Medicina de Precisão , Smartphone , Comportamento Aditivo/terapia , Humanos , Neuroimagem , Transtornos Relacionados ao Uso de Substâncias , Jogos de Vídeo
20.
J Opioid Manag ; 15(4): 285-293, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31637681

RESUMO

OBJECTIVE: To compare dependence characteristics between patients with chronic pain treated within an addiction medicine setting with those attending specialist pain clinics. SETTING AND PATIENTS: Forty patients with chronic non-cancer pain taking opioid analgesics for >1 year were recruited from university-affiliated, tertiary teaching hospital clinics; 20 from an addiction medicine clinic (addiction clinic group) and 20 from specialist pain clinics (pain clinic group). DESIGN AND MAIN OUTCOME MEASURES: Data regarding demographics, past and current substance use, pain history and current daily opioid intake were collected. Patients completed three questionnaires: the Severity of Opioid Dependence Questionnaire, Leeds Dependence Questionnaire, and Pain Disability Index. A novel "Opioid Problem Checklist score" assessing drug-related problems was also determined for each patient. RESULTS: The addiction clinic group were younger, more likely to have experienced drug overdose and had a shorter duration of chronic pain. No significant differences in dependence questionnaire scores were found between groups. However, higher Pain Disability Index scores and higher Opioid Problem Checklist scores (indicating more drug-related problems) were found for the addiction clinic group. CONCLUSIONS: Some degree of dependence was present across both addiction and pain clinic groups, supporting the notion a state of dependence can be identified among chronic pain patients taking opioids long term. Aberrant behaviors were not common in the pain clinic sample, suggesting these patients are unlikely to meet Diagnostic and Statistical Manual of Mental Disorders-V criteria for Substance Use Disorder. However, opioid dependence carries significant risks for relapse, chronicity, morbidity and mortality, warranting specific medical management. Management of such risks should be considered routine care in chronic pain patients taking opioids long term.


Assuntos
Analgésicos Opioides/efeitos adversos , Analgésicos Opioides/uso terapêutico , Comportamento Aditivo , Dor Crônica , Transtornos Relacionados ao Uso de Opioides , Dor Crônica/tratamento farmacológico , Humanos , Transtornos Relacionados ao Uso de Opioides/diagnóstico , Clínicas de Dor , Avaliação de Sintomas
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