Chronic Back Pain Patients Surveyed on Opioid Use

Chronic Back Pain Patients Surveyed on Opioid Use

There’s a study out that says chronic back pain patients who suffer from psychiatric disorders like depression or anxiety are significantly more like to abuse their opioid medication. The study is published in Anesthesiology, the official journal of the American Society of Anesthesiology.

Scientists discovered that patients suffering from a lot of depression or anxiety experienced increase side effects, 50% less improve for back and 75% more opioid abuse compared to patients who didn’t report depression or anxiety.

50 million Americans (including this reporter) suffer from chronic lower back pain.

“High levels of depression and anxiety are common in patients with chronic lower back pain,” said Ajay Wasan, M.D., study author and professor of anesthesiology and psychiatry at the University of Pittsburgh School of Medicine. “Learning that we are able to better predict treatment success or failure by identifying patients with these conditions is significant.”

The research sample was 55 patients were identified as having significant depression and anxiety.

“It’s important for physicians to identify psychiatric disorders prior to deciding whether to prescribe opioids for chronic back pain as well as treat these conditions as part of a multimodal treatment plan,” said Wasan.

“Rather than refusing to prescribe opioids, we suggest that these conditions be treated early and preferably before lower back pain becomes chronic. For those prescribed opioids, successful treatment of underlying psychiatric disorders may improve pain relief and reduce the chance of opioid abuse in these patients.”

The researchers noted that further testing is needed to confirm whether treating psychiatric disorders early in the course of lower back pain can improve pain and function without the use of opioids or other treatments.

Back pain is one of the leading reasons people miss work and a leading cause of disability worldwide.

The Cleveland Clinic posted four things you ought to know about back pain recently.  Here’s what they said.

Do you suffer from chronic lower back pain?

What remedies have you found work to address the pain?

What about osteopathy, chiropractic, acupuncture?

Let us know.

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Authored by: Ed Coghlan

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My labs , xrays and mri’s can not lie, this is beyond cruel, I pray you all casting the stones live as I do if even only for 1 day.


I agree w/ CarenMoore completely. I have a failed back fusion! One side sort of worked, the other however, the titanium rods and screws Broke! That was 15+ yrs ago. I have been disabled since. Doctors will Not even see me. I am Blessed with a Nurse Practitioner, who knows and goes through, constant Pain. Even with the pills, I still have days that demand my attention. Yes, temptations come and go, I have seen people who have surrendered to their minds. My Hope is in The Lord, that does not mean sunshine and rainbows. In the same way, constant pain does not mean we allow depression to win the day. I am new here, I will share my later.


Chronic pain is just that chronic! I’d like to see someone who made up that survey deal with REAL chronic pain & then tell me their not depressed dealing with it. It’s not abuse if you are taking them as prescribed. And I don’t know anyone that has REAL chronic pain that can live without some sort of pain medicine. You try dealing with it day after day month & year after year & see if it doesn’t drive you a little nuts. Why do you think there is such a thing as mercy killings? That’s people that couldn’t stand the pain anymore. I choose not to die so I live on pain medicine to tolerate my body so my daughter doesn’t have to lose her mother. Who are these idiot scientists? They need to spend the government funding they got on trying to find us real cures for spine problems, not wasting that money on trying to take the only thing that helps away from us in the meantime. It’s idiots like them that make me so mad that they weren’t given this ailment instead of the smart people that can’t work anymore because of the ailment & that wish they could work & play again. If they only knew what I would give to move like a normal person again.


Considering the study only looks at 55 patients who present *with* severe depression and anxiety – we’re looking at confirmation bias.

Reality is pain takes from the brain’s serotonin levels – if a person is not managed well; depression is likely and that could mean ‘abuse’ [if abuse is defined as taking the medication in any other way as prescribed. It doesn’t mean you’ll snort your ir’s in a public bathroom anytime soon!]. Anxiety also is common in CPPs these reasons 1) nature of the injury – such as a car accident or assault. 2) side-effects from medications and there are more. None of which mean a patient is going to abuse or kill themselves with the medicine. It means treatment must be *comprehensive* to address all issues.

However one thing concerns me. Doctors are always on high alert. An honest patient who tells their doctor “lately my pain has increased along with my depression” is at risk for having all opioids stopped.

So worried about abuse that a statement an honest patient gives to their doctor *could* put them into a *serious, suicidal depression* and I don’t think anyone wants that or to have their patients *HIDE* these facts from their doctor. What is the balance? I’m not sure m’self after 15yrs CPP which came with it’s own issues.
[was not treated well initially w/fibro and only bulging discs at a time FM was not recognized by the AMA, help was hit or miss. Some doctors told me it was all in my head while others said there were legitimate concerns. I also get white coat syndrome anxiety and situational depression means if the doctor thinks it is in my best interest to stop all medications without alternative the patient ends up feeling hopeless, helpless and alone.]

Come on! You didn’t know these things? Everyone knows this. Of course people who have anxiety and depression are most likely to misuse pain meds. I love how you say it though — it makes it sound like “If you have low back pain you are likely to misuse opioids.” I know you don’t say that, but to a pain patient, it sounds like that and it’s because we hear these keywords all the time, “Misuse, abuse, overuse, low back pain…”

You see we already feel guilty that we have to be on drugs and we’re so afraid of being misunderstood and misinterpreted. We are called “drug addicts, lazy, irresponsible, depressed, anxious, somatic” and other negative words, sometimes to our face. It’s true, people in pain do suffer a lot from anxiety and depression, but it is usually BECAUSE of our pain. Not before, but after! And we try to deal with it and have a happy and productive life, what’s left of it anyways, until we hear these keywords again, then it’s back to feeling guilty.

I know you’re not talking to all pain patients, just to the ones who are new to this game and haven’t been through the medical gauntlet of low back pain treatment yet, but all pain patients read this and your keywords hit home. Read the replies to this and you’ll see. Maybe next time, realize that there are many many of us out there, most of us have years in the business and we could probably perform surgeries at this point. How about an article for people who have been on their meds for 10 years after they have gone through 10 years of low back treatments that didn’t work – only to find out it’s a bone marrow disease and can’t be treated or cured. Got any ideas?

Sandra Gordon

These study results infuriate me. I was diagnosed with depression and anxiety well before my degenerative disc disease and failed back syndrome came into play. I have unmedicated major depression and social anxiety disorders. I tried ALL varieties of antidepressants; not one was effective. I tried numerous medications for my anxiety issues; they too were ineffective. I spent years in therapy and found that to be my best tool. I take Morphine Sulfate and Oxycodone and abuse neither. In the 15 years of living with chronic pain, I have not once asked for more or an early refill.


Yes I have anxiety and depression. Yes I take Vicodin. Until 3 years ago I was able to handle the pain on my own with meditation, herbs etc. But all the sudden my life was snatched out from under me and I was no longer able to function and be happy as I had been. That will put anyone into a depression. Just as I thought I could retire and spend time with family it was taken away from me in a day. I had a total hysterectomy and hip replacement within month’s of each other and tried to recover using crutches and then walker. But that was all after a bad hip injection that left me in s much pain that I cried 24/7 begging God to take me. I’ve tried everything from injections to every drug known to man. In fact just tried fentanyl patches to help me thru the times where the vicodin didn’t dull my pain. Unfortunately I am one of those people that don’t do well on drugs and seriously vicodin is the only thing that has ever dulled the pain enough without making me all drugged out which I refuse to do. I at least want my thoughts and memories in tact since it is the only thing I have left. My back is shot because of OA and my other hip has given out bone to bone along with my knees screaming non stop every day. Every joint in my body all the way to my toes hurts. So I won’t ever let anyone tell me I am addicted, but rather dependent just so I can use my own toilet, sit on my own porch and occasionally whip up a batch of cookies on a good day. Without my “drug” I would be spending my days in bed once again praying each day to die. I spent many years working my tail off in pain to support my family. I deserve some sort of help with this pain as I have grown older and I know what works for me.

I currently live in Pocatello idaho. I have severe cervical stenosis.and a ruptured lower back disk. I went through two surgeries the first to remove a metal BB from my skull so I could get MRI of my entire spine. Because the only other way was ink injected scans. I had a nightmare that started in 2007 with a drunk driver. He ran his truck in front of the truck I was driving 50 miles an hour. I hit his vehicle and tboned him. He fled the scene and was caught by detectives he was sentenced to 4 years in prison I was sentenced to life with chronic pain. My life has been very unsatisfactory and painful. I currently see Dr Knouf in Pocatello idaho. Last July 2014 he sent me in for a regular xray for stenosis which won’t show up on a xray. My doctor was informed about this. And he kicked me off my meds and said it was arthritis and told me to buy a spring for it. His wife also laughed at my tears and said poor baby. I feel so belittled and like they took my life away now I mostly am referencedoing to as a lazy good for nothing person who cries all nite and day. I seriously am afraid the pain I’m in is going to kill me from a heart attack. I am very angry with them and thinking of hiring a lawyer. And suing him for unethical practice and wrongfully torturing me. What can I do to punish this man for taking my health happiness and family from me? He is punishing me for being a crime victim who has chronic pain.

James Ranson

Perhaps if SSRIs showed more promise to those depressed pt populations, opiate abuse/OD would decrease