To reduce the likelihood of opioid use disorder (OUD) among people prescribed opioids for chronic non-cancer pain (CNCP), it is important to identify individual risk factors for OUD among this population. However, until now, little has been known about the relationship between a childhood trauma and OUD risk among people prescribed opioids for CNCP.
A new study by National Drug and Alcohol Research Centre (NDARC) researchers, led by PhD candidate Thomas Santo Jr, describes childhood trauma exposure among a sample of people prescribed opioids for CNCP. They also explore whether childhood trauma exposure is an independent risk factor for OUD among this group in a new paper published by Drug and Alcohol Dependence.
Childhood trauma is the experience of potentially distressing events that threaten a child’s heath or integrity. Examples include sexual abuse, physical abuse, emotional abuse, neglect and witnessing violence. This type of exposure is associated with neurobiological and psychosocial harm that may continue through adulthood.
Using data from 1514 people prescribed opioids long-term (median 4 years) for CNCP recruited from community pharmacies across Australia, five indicators of childhood trauma exposure were characterised. The researchers examined if childhood trauma was associated with development of OUD after they controlled for other OUD risk factors, like a history of mental disorders.
Among people prescribed opioids for CNCP, childhood trauma exposure was common, and associated with an increased risk for developing OUD. The authors also found that a history of childhood trauma was associated with higher rates of other mental and substance use disorders.
The study highlights the critical need for accessible, trauma-informed services and support for people prescribed opioids for CNCP long-term. There is also a need for a more nuanced risk assessment of OUD, including a holistic discussion of individual history and needs. Trauma-informed interventions for people with CNCP and childhood trauma experiences may lower the chances of this population developing OUD.
Given some people may benefit from long-term opioid use, efforts to minimise OUD risk require careful consideration. The findings do not suggest that people with a history of childhood trauma who experience CNCP should not be prescribed opioids to manage their pain.
You can read the full paper published in Drug and Alcohol Dependence here.