Anxiety Sensitivity: A Potential Treatment Target for Opioid Misuse in Chronic Pain

Anxiety sensitivity, or the fear of anxiety-induced physical sensations, may represent an additional treatment target in patients with chronic pain who misuse opioid medications, according to a study published in the American Journal of Drug and Alcohol Abuse.

A total of 429 adults with chronic pain (ie, lasting ≥3 months) and opioid use were included and asked to complete surveys used to gather data on participants’ age, annual income level, sex, education, and symptoms of anxiety and depression.

Mental health was assessed using the 4-item Patient Health Questionnaire-4 (PHQ-4; scores of 0, 4, and ≥5 indicating no depression, depression nearly every day, and moderate to severe depression and/or anxiety, respectively). Other scales used in the study included the 9-item Graded Chronic Pain Scale (GCPS), the 18-item Anxiety Sensitivity Index-3 (ASI-3), the 17-item Current Opioid Misuse Measure (COMM), the 5-item Severity of Dependence Scale (SDS), and self-reported opioid abuse.

A model that incorporated ASI-3 physical and cognitive subscales was found to be predictive of the total COMM score and of the total SDS score (P <.001 for both). ASI-3 cognitive subscale was the only sub-facet predictive of the SDS total score. Physical (P =.001), social (P <.001), and cognitive (P <.001) ASI-3 subscales were all predictive of the number of opioids used by participants to get high during the previous month.

Study limitations include its cross-sectional nature, the exclusion of a large number of participants who initially enrolled in the survey, the predominantly white population, and the reliance on self-reported data.

“These results may provide potentially useful information about a transdiagnostic construct that may be important to better understanding the complexities of opioid misuse,” noted the study authors.

Reference

Rogers AH MA, Kauffman BY MA, Bakhshaie J MD, et al. Anxiety sensitivity and opioid misuse among opioid-using adults with chronic pain [published online March 21, 2019]. Am J Drug Alcohol Abuse. doi:10.1080/00952990.2019.1569670

This article originally appeared on Clinical Pain Advisor