The effects of depression and smoking on pain severity and opioid use in patients with chronic pain

W. Michael Hooten, Yu Shi, Halena M. Gazelka, David Oman Warner

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

Depression and smoking are common comorbid conditions among adults with chronic pain. The aim of this study was to determine the independent effects of depression on clinical pain and opioid use among patients with chronic pain according to smoking status. A retrospective design was used to assess baseline levels of depression, clinical pain, opioid dose (calculated as morphine equivalents), and smoking status in a consecutive series of patients admitted to a 3-week outpatient pain treatment program from September 2003 through February 2007. Depression was assessed using the Centers for Epidemiologic Studies-Depression scale, and clinical pain was assessed using the pain severity subscale of the Multidimensional Pain Inventory. The study cohort (n = 1241) included 313 current smokers, 294 former smokers, and 634 never smokers. Baseline depression (P = .001) and clinical pain (P = .001) were greater among current smokers compared to former and never smokers, and the daily morphine equivalent dose was greater among smokers compared to never smokers (P = .005). In multivariate linear regression analyses, baseline pain severity was independently associated with greater levels of depression, but not with smoking status. However, status as a current smoker was independently associated with greater opioid use (by 27 mg/d), independent of depression scores. The relationship between depression, smoking status, opioid use, and chronic pain is complex, and both depression and smoking status may be potentially important considerations in the treatment of patients with chronic pain who utilize opioids. This study found that pain severity was associated with greater depression but not smoking; however, smoking was associated with greater opioid use, independent of depression.

Original languageEnglish (US)
Pages (from-to)223-229
Number of pages7
JournalPain
Volume152
Issue number1
DOIs
StatePublished - Jan 2011

Fingerprint

Chronic Pain
Opioid Analgesics
Smoking
Depression
Pain
Morphine
Epidemiologic Studies
Linear Models
Cohort Studies
Outpatients
Regression Analysis
Equipment and Supplies

Keywords

  • Depression
  • Pain severity
  • Smoking

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine
  • Neurology
  • Pharmacology

Cite this

The effects of depression and smoking on pain severity and opioid use in patients with chronic pain. / Hooten, W. Michael; Shi, Yu; Gazelka, Halena M.; Warner, David Oman.

In: Pain, Vol. 152, No. 1, 01.2011, p. 223-229.

Research output: Contribution to journalArticle

@article{b526a6bc496e457fbc0e8f88b8c7d7d0,
title = "The effects of depression and smoking on pain severity and opioid use in patients with chronic pain",
abstract = "Depression and smoking are common comorbid conditions among adults with chronic pain. The aim of this study was to determine the independent effects of depression on clinical pain and opioid use among patients with chronic pain according to smoking status. A retrospective design was used to assess baseline levels of depression, clinical pain, opioid dose (calculated as morphine equivalents), and smoking status in a consecutive series of patients admitted to a 3-week outpatient pain treatment program from September 2003 through February 2007. Depression was assessed using the Centers for Epidemiologic Studies-Depression scale, and clinical pain was assessed using the pain severity subscale of the Multidimensional Pain Inventory. The study cohort (n = 1241) included 313 current smokers, 294 former smokers, and 634 never smokers. Baseline depression (P = .001) and clinical pain (P = .001) were greater among current smokers compared to former and never smokers, and the daily morphine equivalent dose was greater among smokers compared to never smokers (P = .005). In multivariate linear regression analyses, baseline pain severity was independently associated with greater levels of depression, but not with smoking status. However, status as a current smoker was independently associated with greater opioid use (by 27 mg/d), independent of depression scores. The relationship between depression, smoking status, opioid use, and chronic pain is complex, and both depression and smoking status may be potentially important considerations in the treatment of patients with chronic pain who utilize opioids. This study found that pain severity was associated with greater depression but not smoking; however, smoking was associated with greater opioid use, independent of depression.",
keywords = "Depression, Pain severity, Smoking",
author = "Hooten, {W. Michael} and Yu Shi and Gazelka, {Halena M.} and Warner, {David Oman}",
year = "2011",
month = "1",
doi = "10.1016/j.pain.2010.10.045",
language = "English (US)",
volume = "152",
pages = "223--229",
journal = "Pain",
issn = "0304-3959",
publisher = "Elsevier",
number = "1",

}

TY - JOUR

T1 - The effects of depression and smoking on pain severity and opioid use in patients with chronic pain

AU - Hooten, W. Michael

AU - Shi, Yu

AU - Gazelka, Halena M.

AU - Warner, David Oman

PY - 2011/1

Y1 - 2011/1

N2 - Depression and smoking are common comorbid conditions among adults with chronic pain. The aim of this study was to determine the independent effects of depression on clinical pain and opioid use among patients with chronic pain according to smoking status. A retrospective design was used to assess baseline levels of depression, clinical pain, opioid dose (calculated as morphine equivalents), and smoking status in a consecutive series of patients admitted to a 3-week outpatient pain treatment program from September 2003 through February 2007. Depression was assessed using the Centers for Epidemiologic Studies-Depression scale, and clinical pain was assessed using the pain severity subscale of the Multidimensional Pain Inventory. The study cohort (n = 1241) included 313 current smokers, 294 former smokers, and 634 never smokers. Baseline depression (P = .001) and clinical pain (P = .001) were greater among current smokers compared to former and never smokers, and the daily morphine equivalent dose was greater among smokers compared to never smokers (P = .005). In multivariate linear regression analyses, baseline pain severity was independently associated with greater levels of depression, but not with smoking status. However, status as a current smoker was independently associated with greater opioid use (by 27 mg/d), independent of depression scores. The relationship between depression, smoking status, opioid use, and chronic pain is complex, and both depression and smoking status may be potentially important considerations in the treatment of patients with chronic pain who utilize opioids. This study found that pain severity was associated with greater depression but not smoking; however, smoking was associated with greater opioid use, independent of depression.

AB - Depression and smoking are common comorbid conditions among adults with chronic pain. The aim of this study was to determine the independent effects of depression on clinical pain and opioid use among patients with chronic pain according to smoking status. A retrospective design was used to assess baseline levels of depression, clinical pain, opioid dose (calculated as morphine equivalents), and smoking status in a consecutive series of patients admitted to a 3-week outpatient pain treatment program from September 2003 through February 2007. Depression was assessed using the Centers for Epidemiologic Studies-Depression scale, and clinical pain was assessed using the pain severity subscale of the Multidimensional Pain Inventory. The study cohort (n = 1241) included 313 current smokers, 294 former smokers, and 634 never smokers. Baseline depression (P = .001) and clinical pain (P = .001) were greater among current smokers compared to former and never smokers, and the daily morphine equivalent dose was greater among smokers compared to never smokers (P = .005). In multivariate linear regression analyses, baseline pain severity was independently associated with greater levels of depression, but not with smoking status. However, status as a current smoker was independently associated with greater opioid use (by 27 mg/d), independent of depression scores. The relationship between depression, smoking status, opioid use, and chronic pain is complex, and both depression and smoking status may be potentially important considerations in the treatment of patients with chronic pain who utilize opioids. This study found that pain severity was associated with greater depression but not smoking; however, smoking was associated with greater opioid use, independent of depression.

KW - Depression

KW - Pain severity

KW - Smoking

UR - http://www.scopus.com/inward/record.url?scp=78650414308&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78650414308&partnerID=8YFLogxK

U2 - 10.1016/j.pain.2010.10.045

DO - 10.1016/j.pain.2010.10.045

M3 - Article

C2 - 21126821

AN - SCOPUS:78650414308

VL - 152

SP - 223

EP - 229

JO - Pain

JF - Pain

SN - 0304-3959

IS - 1

ER -