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Published on: July 29, 2014
The Association Between Perceived Injustice and Opioid Craving in Patients With Chronic Pain: The Mediating Role of
Maria Verner1, Amanda Sirois, Emmanuelle Coutu-Nadeau
1From the Faculty of Dentistry, McGill University, Montreal, Canada (MV, AS, CF, MOM); Department of Psychology, McGill University, Montreal, Canada (EC-N); Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Canada (JC); Department of Anesthesia, McGill University, Montreal, Canada (MOM).
Objectives:
The first objective of this study was to examine the association between perceived injustice and opioid craving in patients with chronic pain who are prescribed opioids. We also examined whether pain intensity, negative affect, or catastrophizing mediated this association.
Methods:
In this longitudinal diary study, patients (n = 103) completed a questionnaire assessing perceived injustice and then completed daily measures of pain intensity, negative affect, catastrophizing, and opioid craving for 14 consecutive days.
Results:
A significant association was found between perceived injustice and opioid craving ( P < 0.01), with higher levels of perceived injustice being associated with heightened levels of opioid craving. A 2-1-1 multilevel mediation analysis indicated that the association between perceived injustice and craving was significantly mediated by catastrophizing ( P < 0.05).
Conclusions:
The present study provides new insights into the factors that might contribute to opioid craving in patients with chronic pain. Our findings suggest that perceived injustice might lead to increased catastrophizing and, in turn, heightened daily levels of opioid craving. These findings could have implications for chronic pain management clinicians who prescribe opioids.
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