慢性的な痛みを持つ人々の間で認知された差別と処方されたオピオイドの乱用との直接的および間接的な関連を調べる
Patricia Timmons1, Lakeya S McGill2, Rachel V Aaron3
1College of Health Solutions, Arizona State University.
Stigma and health
|September 2, 2025
まとめ
差別は慢性疼痛患者の処方オピオイドの乱用の増加と関連しています また,不安や鬱を高めますが,痛みの重さや心理的な症状によって媒介されるわけではありません.
科学分野:
- 心理社会的ストレス要因
- 慢性痛の治療
- オピオイド使用行動
背景:
- 問題のあるオピオイド使用に関連した重要な心理社会的ストレス因子です.
- 慢性的な痛みを持つ人々にとって 差別とオピオイドの乱用の間の経路を理解することは 極めて重要です
研究 の 目的:
- 痛みの重度,痛みの干渉,不安,うつ症状が 差別と処方オピオイドの乱用行動との関連を媒介するかどうかを調査する.
- 慢性的な痛みを持つ人々の差別と処方オピオイドの乱用との直接的な関連を調べる
主な方法:
- 234人の参加者を対象とした長期的研究では 慢性的な痛みに対してオピオイドが処方されました
- 経路分析とパーセンチルブートストラップ方法は,仮説化されたメディエーションモデルをテストするために使用されました.
- 基礎値と12ヶ月のフォローアップで収集されたデータで,社会人口学的共変数を制御した.
主要な成果:
- ベースラインの差別は12ヶ月で処方オピオイドの乱用行動の増加と有意に関連していました (p=0. 020).
- また,発症時の差別は12ヶ月後に不安 (p<. 001) とうつ病症状 (p<. 001) の増加と有意に関連していました.
- 痛みの重さ,痛みの干渉,不安,うつ症状は,差別とオピオイドの乱用を関連付ける有意なメディエーターではなかった.
結論:
- 差別は慢性疼痛患者における処方オピオイドの乱用に直接寄与する可能性があります.
- 差別は不安やうつ病の症状を高める 危険因子であり 臨床的な影響も伴います
- この研究では,この関係における痛みの重さ,痛みの干渉,不安,またはうつ症状のメディエーターの証拠は見つかりませんでした.
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