The Association Between Catastrophizing and Craving in Patients with Chronic Pain Prescribed Opioid Therapy: a Preliminary Analysis

Overview

Journal Pain Med

Specialties Critical Care
Neurology
Psychiatry

Date 2014 Mar 12

PMID 24612286

Citations 32

Authors

Marc O Martel

Robert N Jamison

Ajay D Wasan

Robert R Edwards

Affiliations

Soon will be listed here.

Abstract

Background: A growing number of studies have shown that opioid craving (i.e., the perceived need or desire to consume opioids) is one of the strongest determinants of prescription opioid misuse in patients with chronic pain prescribed opioid therapy. To date, however, the factors that are associated with craving in patients with pain remain largely unexplored. Based on previous research, there is reason to believe that catastrophizing might be associated with heightened opioid craving.

Objectives: To test the hypothesis that catastrophizing would be associated with heightened craving in patients with chronic pain prescribed long-term opioid therapy.

Design And Subjects, And Methods: In this cross-sectional study, 109 patients with chronic pain were asked to provide self-reports of catastrophizing and craving. Patients also provided self-reports of pain intensity and depressive symptoms.

Results: We found that higher levels of catastrophizing were associated with higher levels of craving. Importantly, results of a regression analysis revealed that the association between catastrophizing and craving remained significant even after controlling for a host of demographic (i.e., age, sex), psychological (i.e., depressive symptoms), medical (i.e., pain intensity, pain duration), and medication regimen (i.e., opioid doses) variables.

Conclusions: Our preliminary findings provide valuable new insights into the determinants of craving in patients with pain. The finding that catastrophizing was associated with craving even after controlling for a host of demographic, psychological, medical, and medication regimen variables is particularly striking, and raises questions concerning the factors that underlie the association between catastrophizing and craving in patients prescribed opioid therapy.

Citing Articles

Pain Catastrophizing and Substance Misuse: A Scoping Review of the Literature.

Bichon J, Bailey A, Ford S, Lesser V, McHugh R Harv Rev Psychiatry. 2025; 33(1):8-30.

PMID: 39761442 PMC: 11881806. DOI: 10.1097/HRP.0000000000000415.

Treating Anxiety-Based Cognitive Distortions Pertaining to Somatic Perception for Better Chronic Pain Outcomes: A Recommendation for Better Practice in the Present Day and the Cyber Age of Medicine.

Silva M J Clin Med. 2024; 13(19).

PMID: 39407983 PMC: 11478175. DOI: 10.3390/jcm13195923.

Sex differences in comorbid pain and opioid use disorder: A scoping review.

DeVito E, Ameral V, Sofuoglu M Br J Clin Pharmacol. 2024; 90(12):3067-3083.

PMID: 39168150 PMC: 11604518. DOI: 10.1111/bcp.16218.

"Catastrophization", Its Weaponization, and Opiophobia: A Perfect Landscape for Unnecessary Harms, or "Catastrophization About Catastrophization"?.

Schatman M, Levin D J Pain Res. 2024; 17:171-175.

PMID: 38204580 PMC: 10778136. DOI: 10.2147/JPR.S453155.

The moderating effect of resting heart rate variability on the relationship between pain catastrophizing and depressed mood: an empirical study.

Kocsel N, Galambos A, Szoke J, Kokonyei G Biol Futur. 2023; 75(1):29-39.

PMID: 37934392 DOI: 10.1007/s42977-023-00190-3.

References

Dawe S, Loxton N . The role of impulsivity in the development of substance use and eating disorders. Neurosci Biobehav Rev. 2004; 28(3):343-51. DOI: 10.1016/j.neubiorev.2004.03.007. View

Martel M, Dolman A, Edwards R, Jamison R, Wasan A . The association between negative affect and prescription opioid misuse in patients with chronic pain: the mediating role of opioid craving. J Pain. 2013; 15(1):90-100. PMC: 3877217. DOI: 10.1016/j.jpain.2013.09.014. View

Volkow N, Baler R . Addiction science: Uncovering neurobiological complexity. Neuropharmacology. 2013; 76 Pt B:235-49. PMC: 3818510. DOI: 10.1016/j.neuropharm.2013.05.007. View

Shi J, Li S, Zhang X, Wang X, Le Foll B, Zhang X . Time-dependent neuroendocrine alterations and drug craving during the first month of abstinence in heroin addicts. Am J Drug Alcohol Abuse. 2009; 35(5):267-72. DOI: 10.1080/00952990902933878. View

Muris P, Meesters C, van den Hout A, Wessels S, Franken I, Rassin E . Personality and temperament correlates of pain catastrophizing in young adolescents. Child Psychiatry Hum Dev. 2007; 38(3):171-81. PMC: 2778719. DOI: 10.1007/s10578-007-0054-9. View

Williams T, Davies S, Taylor L, Daglish M, Hammers A, Brooks D . Brain opioid receptor binding in early abstinence from alcohol dependence and relationship to craving: an [11C]diprenorphine PET study. Eur Neuropsychopharmacol. 2009; 19(10):740-8. DOI: 10.1016/j.euroneuro.2009.06.007. View

Tan G, Jensen M, Thornby J, Shanti B . Validation of the Brief Pain Inventory for chronic nonmalignant pain. J Pain. 2004; 5(2):133-7. DOI: 10.1016/j.jpain.2003.12.005. View

Vowles K, Gross R, Sorrell J . Predicting work status following interdisciplinary treatment for chronic pain. Eur J Pain. 2004; 8(4):351-8. DOI: 10.1016/j.ejpain.2003.10.009. View

Friedel R . Dopamine dysfunction in borderline personality disorder: a hypothesis. Neuropsychopharmacology. 2004; 29(6):1029-39. DOI: 10.1038/sj.npp.1300424. View

10.

Edwards R, Cahalan C, Calahan C, Mensing G, Smith M, Haythornthwaite J . Pain, catastrophizing, and depression in the rheumatic diseases. Nat Rev Rheumatol. 2011; 7(4):216-24. DOI: 10.1038/nrrheum.2011.2. View

11.

Volkow N, Fowler J, Wang G . The addicted human brain: insights from imaging studies. J Clin Invest. 2003; 111(10):1444-51. PMC: 155054. DOI: 10.1172/JCI18533. View

12.

Wasan A, Butler S, Budman S, Fernandez K, Weiss R, Greenfield S . Does report of craving opioid medication predict aberrant drug behavior among chronic pain patients?. Clin J Pain. 2009; 25(3):193-8. PMC: 2664529. DOI: 10.1097/AJP.0b013e318193a6c4. View

13.

Gracely R, Geisser M, Giesecke T, Grant M, Petzke F, Williams D . Pain catastrophizing and neural responses to pain among persons with fibromyalgia. Brain. 2004; 127(Pt 4):835-43. DOI: 10.1093/brain/awh098. View

14.

Shedler J, Westen D . Refining personality disorder diagnosis: integrating science and practice. Am J Psychiatry. 2004; 161(8):1350-65. DOI: 10.1176/appi.ajp.161.8.1350. View

15.

Edwards R, Bingham 3rd C, Bathon J, Haythornthwaite J . Catastrophizing and pain in arthritis, fibromyalgia, and other rheumatic diseases. Arthritis Rheum. 2006; 55(2):325-32. DOI: 10.1002/art.21865. View

16.

Michna E, Ross E, Hynes W, Nedeljkovic S, Soumekh S, Janfaza D . Predicting aberrant drug behavior in patients treated for chronic pain: importance of abuse history. J Pain Symptom Manage. 2004; 28(3):250-8. DOI: 10.1016/j.jpainsymman.2004.04.007. View

17.

Passik S, Lowery A . Psychological variables potentially implicated in opioid-related mortality as observed in clinical practice. Pain Med. 2011; 12 Suppl 2:S36-42. PMC: 4112122. DOI: 10.1111/j.1526-4637.2011.01130.x. View

18.

Wideman T, Sullivan M . Differential predictors of the long-term levels of pain intensity, work disability, healthcare use, and medication use in a sample of workers' compensation claimants. Pain. 2010; 152(2):376-383. DOI: 10.1016/j.pain.2010.10.044. View

19.

Kober H, Kross E, Mischel W, Hart C, Ochsner K . Regulation of craving by cognitive strategies in cigarette smokers. Drug Alcohol Depend. 2009; 106(1):52-5. PMC: 2814914. DOI: 10.1016/j.drugalcdep.2009.07.017. View

20.

Conklin C, Westen D . Borderline personality disorder in clinical practice. Am J Psychiatry. 2005; 162(5):867-75. DOI: 10.1176/appi.ajp.162.5.867. View