Relative Pain Levels in Patients at High Risk for Substance Misuse

Robert N. Jamison, PhD

Pain Management Center
Departments of Anesthesia and Psychiatry
Brigham and Women's Hospital
Harvard Medical School
Boston, Massachusetts

The Screener and Opioid Assessment for Patients with Pain (SOAPP) is a brief self-report questionnaire that assesses patients for risk factors associated with potential opioid misuse. Jamison et al. sought to identify differences among patients with chronic pain who were stratified as either low or high risk based on their SOAPP scores. At baseline, high-risk patients reported significantly higher levels of pain intensity, activity interference, pain catastrophizing, disability, and depressed mood. The only difference observed over time, however, was higher self-reported pain levels in the high-risk group. These results suggest that the SOAPP may allow clinicians not only to stratify patients based on the risk for opioid-related aberrant behaviors, but also to identify patients who may experience more pain.

References

Jamison RN, Link CL, Marceau LD. Do pain patients at high risk for substance misuse experience more pain? A longitudinal outcomes study. Pain Med. 2009;10(6):1084-94.
Butler SF, Fernandez K, Benoit C, Budman SH, Jamison RN. Validation of the revised Screener and Opioid Assessment for Patients with Pain (SOAPP-R). J Pain. 2008;9(4):360-72.
Silverman SM. Opioid induced hyperalgesia: clinical implications for the pain practitioner. Pain Physician. 2009;12(3):679-84.

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