9781422279632

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Chronic Pain and Prescription Painkillers

Chronic Pain and Depression A ccording to the Perelman School of Medicine, almost one-half of all primary care patients in America experience persistent pain. Many of these patients also suffer from major depressive disorder (MDD), which is a depressed mood that interferes with daily life. People with MDD are more likely to report chronic pain, and people with chronic pain are more likely to develop MDD. Suicide is therefore closely linked to people suffering from both conditions. Suicidal ideation, or suicidal thoughts, may stem from being dis- abled or unemployed, poor sleep, and feelings of helplessness caused by chronic pain. In a study of 88 patients at several pain clinics, 24 per- cent reported active or passive suicidal ideation. Active suicidal ideation is the desire to die and having a specific plan for how the death will be carried out. Passive suicidal ideation is the desire to die without having a specific plan for how the death will happen. A study of 153 individuals with chronic non-cancer pain revealed that 19 percent had passive suicidal ideation, 13 percent had active sui- cidal ideation, and 5 percent had a plan for suicide. In most cases, drug overdose was the chosen method for suicide. People with chronic pain are twice as likely to commit suicide, com- pared to people without chronic pain. General risk factors include prior suicide attempts, history of suicide in the family, and depression. Pain- specific risk factors include widespread and intense pain accompanied by insomnia. Considering the high rate of depression in the pain pop- ulation, doctors treating chronic pain should screen patients for depression during each visit.