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Chronic low back pain linked to illicit drug use: study

back pain

Washington: People living with chronic low back pain are more likely to use illicit drugs – including marijuana, cocaine, heroin and methamphetamine – compared to those without back pain, a new study has claimed.

In addition, chronic low back pain (cLBP) patients with a history of illicit drug use are more likely to have a current prescription for opioid analgesic (pain-relieving) drugs, according to the new research by Dr Anna Shmagel of University of Minnesota in the US and colleagues.

While it is not clear which direction the association runs, the patterns of illicit drug use may have implications for decisions about prescribing opioids for patients with back pain. The researchers analysed survey responses from more than
5,000 US adults (aged 20 to 69) from a nationally representative health study.

About 13 per cent of respondents met the study definition of cLBP – back pain present for three months or longer. The confidential survey also asked participants about their use of illicit drugs – marijuana, cocaine, heroin and
methamphetamine. The results suggested that back pain was linked to higher
rates of illicit drug use. About 49 per cent of adults with cLBP said they had ever used illicit drugs, compared to 43 per cent of those without cLBP.

Rates of current illicit drug use (within the past 30 days) were also higher in the cLBP group: 14 per cent versus nine per cent. All four specific drugs in the survey were more commonly used by respondents with cLBP. Rates of lifetime use were about 46.5 versus 42 per cent for marijuana, 22 versus 14 per cent for cocaine, nine versus five per cent for methamphetamine, and five versus two percent for heroin.

After adjustment for other factors, participants with cLBP were more than twice as likely to report methamphetamine and heroin use. The results also suggested a link between illicit drugs and prescription opioids among patients with cLBP. Subjects who had ever used illicit drugs were more likely to have an active prescription for opioid analgesics: 22.5 per cent versus 15 per cent.

Current illicit drug users were also more likely to have an opioid prescription, although that difference was not statistically significant. Prescription opioids are widely used by patients with cLBP, raising concerns about addiction, misuse and accidental overdose, researchers said. The study was published in the journal Spine.

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