Pain, the Opioid Epidemic, and Depression

Name: Pain, the Opioid Epidemic, and Depression
Brand: OUP eBook
Price: 64.49 EUR
Availability: OnlineOnly

Jeffrey F. Scherrer Jane C. MD Ballantyne(Herausgeber*in)

OUP eBook (Verlag)

Erschienen am 16. September 2024

200 Seiten

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978-0-19-767524-3 (ISBN)

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Beschreibung

Long-term prescription opioid use occurs in a substantial proportion of new opioid users. Most concerning is that high risk patients with comorbid depression, anxiety, nicotine dependence, and substance use disorders, compared to patients without these factors, continue to be prescribed higher opioid doses for longer durations, and are more likely to receive opioids with high abuse potential. To understand this phenomenon, we must consider the relationships between pain, mental illness, substance use disorder and long-term prescription opioid use. While separate fields have investigated the bi-directional relationships between depression, pain, and long-term prescription opioid use independently of one another, there is no text which has brought together the complex interaction of all three together. Drawing on contributions from neuroscience, pain psychiatry, clinical epidemiology, pharmacoepidemiology, clinical trials and research on social determinants of health, Pain, the Opioid Epidemic, and Depression is the first book to integrate currently siloed areas of investigation and clinical knowledge. This book takes a comprehensive approach, from neurophysiology to epidemiology to clinical practice, and explains the processes driving maintenance of chronic pain, persistent depression, and long-term prescription opioid use, as well as taper and buprenorphine treatment for opioid use disorder. Readers will come to understand the central role of depression, other psychiatric disorders, and social determinants that contribute to pain management outcomes, the opioid epidemic, and our response to opioid dependence and opioid use disorder. By taking a multidisciplinary approach to compiling what is known about the relationships between pain, depression, other psychiatric disorders and opioids, this volume will be a valuable clinical resource for a range of healthcare and mental health professionals who encounter chronic pain and comorbid mood disorders, while also spawning new directions for researchers.

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Inhalt

Cover
Half Title
Title Page
Copyright Page
Dedication
Contents
Acknowledgments
List of Abbreviations and Acronyms
List of Contributors
1 Overview and Purpose
1.1 Introduction
1.2 Chapter Overview
1.3 Key Concepts to Assist Readers
1.4 Overview of the Non-Cancer Pain, Opioid Epidemic, and Depression Tripartite
1.5 Clinical and Public Health Relevance
References
2 Neurophysiology of Pain, Depression, and Exogenous Opioids
2.1 Introduction
2.2 Neurophysiological Mechanisms Underlying Comorbid Pain and Depression
2.3 Common Underlying Physiology
2.4 The Role of Opioid Medications on the Link Between Pain and Depression
2.5 Hedonic Capacity Related to Chronic Opioid Use
2.6 Conclusion
References
3 Looking Beyond Tissue Damage: Pain as a Homeostatic Emotion
3.1 Introduction
3.2 Alternative View: Pain as Interoceptive Homeostatic Emotion
3.3 Colin Klein's Imperative Theory of Pain
3.4 Pain in the Brain: From Pain Matrix to Salience Network
3.5 The Relation of Pain to Hurt and Suffering
3.6 Pain, Anxiety, and Depression as Homeostatic Emotions
3.7 Opioids, Pain, and Depression
3.8 Conclusion
References
4 Prescription Opioid Use and Risk of Depression and Worsening Mental Health
4.1 Overview
4.2 Measuring Non-Cancer Pain
4.3 Defining Long-Term Opioid Therapy
4.4 Considerations for Standardizing Dosage
4.5 Pain as a Key Confounding Factor
4.6 Propensity Scores and Inverse Probability of Treatment Weighting
4.7 Summary of Evidence from Existing Cross-Sectional Studies
4.8 Results from Existing Retrospective Cohort Studies: Risks for New-Onset Depression
4.9 Evidence from Retrospective Cohort Studies: LTOT and Risk for Depression
4.10 Results from Prospective Cohort Studies
4.11 Escalating Dose and Frequency of Use May Explain Risk for New-Onset Depression
4.12 Is Depression a Side Effect or Consequence of Long-Term Opioid Use?
4.13 Does Opioid Use Lead Specifically to Major Depressive Episodes or to Psychopathology in General?
4.14 Does Long-Term Prescription Opioid Use Cause Depression?
4.15 Potential Biological Mechanisms
4.16 Psychosocial Mechanisms
4.17 Public Health and Clinical Relevance
4.18 Conclusion
References
5 Depression and Pain: Bidirectional Relationship and Changes with Psychological Treatment
5.1 Introduction
5.2 Psychological Treatments for Co-Occurring Chronic Pain and Depression
5.3 Psychological Interventions to Reduce Prescription Opioid Use Among Individuals with Chronic Pain
5.4 Challenges in Managing Comorbid Pain, Depression, and Opioid Use and Potential Solutions
5.5 Conclusion
References
6 Other Psychiatric Disorders, Psychosocial Factors, Sleep, and Pain
6.1 Introduction
6.2 Chronic Pain and Anxiety
6.3 Chronic Pain and Posttraumatic Stress Disorder
6.4 Chronic Pain and Bipolar Disorder
6.5 Pain and Schizophrenia
6.6 Research Gaps and Future Directions for the Study of Comorbid Chronic Pain and Psychiatric Disorders
6.7 Conclusion
References
7 The Impact of Social and Structural Determinants on Depression, Prescription Opioid Use, Opioid Misuse, and Opioid Use Disorder
7.1 Introduction
7.2 Impact of Economic Stability
7.3 Impact of Education Access and Quality
7.4 Impact of Healthcare Access and Quality
7.5 Impact of Neighborhood and Built Environment
7.6 Impact of Social and Community Context and Connectedness
7.7 Conclusion
References
8 Opioid Taper and Complex Prescription Opioid Dependence: The Role of Depression
8.1 Introduction
8.2 Defining Opioid Dependence
8.3 Pain and Endogenous Opioid Systems
8.4 Opponent Processes
8.5 Allostasis
8.6 Depression in the Context of Opioid Use and Opioid Taper
8.7 Treatment in Interdisciplinary Pain Programs During Opioid Taper
8.8 Future Research Directions
8.9 Conclusion
References
9 Potential Role for Buprenorphine in the Management of Comorbid Depression Among People with Chronic Pain and Long-Term Opioid Therapy Dependence
9.1 Introduction
9.2 History of Therapeutic Use of Buprenorphine to Treat Depression
9.3 Buprenorphine Basic Pharmacology
9.4 Low-Dose Buprenorphine in Treatment-Refractory Depression Among Opioid-Naïve Individuals
9.5 Buprenorphine in Treatment of Depression Comorbid with Opioid Use Disorder
9.6 Buprenorphine in Treatment of Depression Comorbid with Chronic Pain and Long-Term Opioid Therapy
9.7 How Long-Term Opioid Use for Pain Can Lead to More Pain and Depression
9.8 Buprenorphine Use in LTOT Dependence-Induced OICP and Associated Depression
9.9 Conclusion
References
10 Future Directions in Pain Management: Implications for Depression and Mental Health
10.1 Research to Determine If Treating Depression and Other Psychiatric Disorders to Remission Leads to Safer Opioid Prescribing
10.2 Balancing Safe Opioid Prescribing with Access to Pain Management Among Patients with Comorbid Depression
10.3 Care Delivery Models to Increase Safe Opioid Prescribing for Complex Patients with Comorbid Pain and Psychiatric Conditions
10.4 Investing to End the Opioid Epidemic
References
Index

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