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

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Anxiety sensitivity may represent an additional treatment target in patients with chronic pain who misuse opioid medications.

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.

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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.


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