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Patients' perception about opioids and addiction in South Korea

  • Kim, Cho Long (Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine) ;
  • Hong, Sung Jun (Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital) ;
  • Lim, Yun Hee (Department of Anesthesiology and Pain Medicine, Inje University Sanggye Paik Hospital) ;
  • Jeong, Jae Hun (Department of Anesthesiology and Pain Medicine, Jeong-clinic) ;
  • Moon, Ho Sik (Department of Anesthesiology and Pain Medicine, The Catholic University of Korea, Eunpyeong St. Mary's Hospital) ;
  • Choi, Hey Ran (Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital) ;
  • Park, Sun Kyung (Department of Anesthesiology and Pain Medicine, Jeju National University School of Medicine) ;
  • Kim, Jung Eun (Department of Anesthesiology and Pain Medicine, Hallym University Kangnam Sacred Heart Hospital) ;
  • You, Hakjong (Department of Anesthesiology and Pain Medicine, Kangdong Sacred Heart Hospital) ;
  • Kim, Jae Hun (Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine)
  • Received : 2020.01.02
  • Accepted : 2020.04.03
  • Published : 2020.07.01

Abstract

Background: Chronic pain affects approximately 22% of the world's population. Opioids can be useful in chronic pain management. However, some patients have negative perception of opioids. The purpose of this research was to evaluate patients' perception about opioids and investigate problems associated with prescribing and taking opioids in South Korea. Methods: Patients who visited a pain clinic in 14 university hospitals of South Korea from September through October 2018 were asked to complete anonymous questionnaires about taking opioids. Results: Of the 368 patients that were surveyed (female 53.3%, male 46.7%), 56.8% were prescribed opioids. In the opioid group, 92.8% patients had heard of opioids from their doctor and 72.6% of them had a positive perception about opioids. The side effects associated with opioid use were constipation (35.4%), dizziness (24.6%), nausea and vomiting (17.4%), dysuria (6.2%), and addiction (2.0%). In the no opioid group, the primary sources of information about opioids were doctors (49.2%), mass media (30.8%), and the internet (16.2%). The main reasons why 39.0% patients did not take opioids were fear of addiction (57.7%) and side effects (38.5%). There were 71.5% and 60.9% patients in the opioid and no opioid group, respectively, who wished to take opioids when their numeric rating scale pain score was ≥ 7. Conclusions: Perception of opioids among patients who take them was either neutral or positive. However, 39.0% patients who have not been prescribed opioids did not want an opioid prescription, citing fear of addiction and side effects as the primary reasons.

Keywords

References

  1. Gureje O, Von Korff M, Simon GE, Gater R. Persistent pain and well-being: a World Health Organization Study in primary care. JAMA 1998; 280: 147-51. https://doi.org/10.1001/jama.280.2.147
  2. Ahacic K, Kareholt I. Prevalence of musculoskeletal pain in the general Swedish population from 1968 to 2002: age, period, and cohort patterns. Pain 2010; 151: 206-14. https://doi.org/10.1016/j.pain.2010.07.011
  3. Toth C, Lander J, Wiebe S. The prevalence and impact of chronic pain with neuropathic pain symptoms in the general population. Pain Med 2009; 10: 918-29. https://doi.org/10.1111/j.1526-4637.2009.00655.x
  4. Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain 2006; 10: 287-333. https://doi.org/10.1016/j.ejpain.2005.06.009
  5. Fine PG. Long-term consequences of chronic pain: mounting evidence for pain as a neurological disease and parallels with other chronic disease states. Pain Med 2011; 12: 996-1004. https://doi.org/10.1111/j.1526-4637.2011.01187.x
  6. Dworkin RH, O'Connor AB, Audette J, Baron R, Gourlay GK, Haanpaa ML, et al. Recommendations for the pharmacological management of neuropathic pain: an overview and literature update. Mayo Clin Proc 2010; 85(3 Suppl): S3-14.
  7. Attal N, Cruccu G, Baron R, Haanpaa M, Hansson P, Jensen TS, et al. EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol 2010; 17: 1113-e88. https://doi.org/10.1111/j.1468-1331.2010.02999.x
  8. Kim YD. Opioid: toward an effective strategy for better use. Korean J Pain 2019; 32: 67-8. https://doi.org/10.3344/kjp.2019.32.2.67
  9. Moore RA, McQuay HJ. Prevalence of opioid adverse events in chronic non-malignant pain: systematic review of randomised trials of oral opioids. Arthritis Res Ther 2005; 7: R1046-51. https://doi.org/10.1186/ar1782
  10. Sun VC, Borneman T, Ferrell B, Piper B, Koczywas M, Choi K. Overcoming barriers to cancer pain management: an institutional change model. J Pain Symptom Manage 2007; 34: 359-69. https://doi.org/10.1016/j.jpainsymman.2006.12.011
  11. Maltoni M. Opioids, pain, and fear. Ann Oncol 2008; 19: 5-7. https://doi.org/10.1093/annonc/mdm555
  12. Baik JS. Guidelines for prescribing opioids for chronic noncancer pain in Korea: can you overcome "opiophobia"? Korean J Pain 2017; 30: 1-2. https://doi.org/10.3344/kjp.2017.30.1.1
  13. Han T. Opioids in cancer and non-cancer pain management in Korea: the past, present and future. Eur J Pain 2001; 5 Suppl A: 73-8. https://doi.org/10.1053/eujp.2001.0284
  14. Oh TK, Jeon YT, Choi JW. Trends in chronic opioid use and association with five-year survival in South Korea: a population-based cohort study. Br J Anaesth 2019; 123: 655-63. https://doi.org/10.1016/j.bja.2019.08.012
  15. Lee JH. The opioid epidemic and crisis in US: how about Korea? Korean J Pain 2019; 32: 243-4. https://doi.org/10.3344/kjp.2019.32.4.243
  16. Consensus Statement from the American Academy of Pain Medicine and the American Pain Society. The use of opioids for the treatment of chronic pain. J Pharm Care Pain Symptom Control 2010; 6: 97-102. https://doi.org/10.1300/J088v06n01_08
  17. Kalso E, Edwards JE, Moore RA, McQuay HJ. Opioids in chronic non-cancer pain: systematic review of efficacy and safety. Pain 2004; 112: 372-80. https://doi.org/10.1016/j.pain.2004.09.019
  18. Noble M, Treadwell JR, Tregear SJ, Coates VH, Wiffen PJ, Akafomo C, et al. Long-term opioid management for chronic noncancer pain. Cochrane Database Syst Rev 2010; 2010: CD006605.
  19. Furlan AD, Sandoval JA, Mailis-Gagnon A, Tunks E. Opioids for chronic noncancer pain: a meta-analysis of effectiveness and side effects. CMAJ 2006; 174: 1589-94. https://doi.org/10.1503/cmaj.051528
  20. Eisenberg E, McNicol ED, Carr DB. Efficacy and safety of opioid agonists in the treatment of neuropathic pain of nonmalignant origin: systematic review and meta-analysis of randomized controlled trials. JAMA 2005; 293: 3043-52. https://doi.org/10.1001/jama.293.24.3043
  21. Ballantyne JC. Opioid analgesia: perspectives on right use and utility. Pain Physician 2007; 10: 479-91. https://doi.org/10.36076/ppj.2007/10/479
  22. Portenoy RK, Farrar JT, Backonja MM, Cleeland CS, Yang K, Friedman M, et al. Long-term use of controlled-release oxycodone for noncancer pain: results of a 3-year registry study. Clin J Pain 2007; 23: 287-99. https://doi.org/10.1097/AJP.0b013e31802b582f
  23. Anderson VC, Burchiel KJ. A prospective study of long-term intrathecal morphine in the management of chronic nonmalignant pain. Neurosurgery 1999; 44: 289-300. https://doi.org/10.1097/00006123-199902000-00026
  24. Fishbain DA, Cole B, Lewis J, Rosomoff HL, Rosomoff RS. What percentage of chronic nonmalignant pain patients exposed to chronic opioid analgesic therapy develop abuse/addiction and/or aberrant drug-related behaviors? A structured evidence-based review. Pain Med 2008; 9: 444-59. https://doi.org/10.1111/j.1526-4637.2007.00370.x
  25. Juurlink DN, Dhalla IA. Dependence and addiction during chronic opioid therapy. J Med Toxicol 2012; 8: 393-9. https://doi.org/10.1007/s13181-012-0269-4
  26. Webster LR, Webster RM. Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the Opioid Risk Tool. Pain Med 2005; 6: 432-42. https://doi.org/10.1111/j.1526-4637.2005.00072.x
  27. Kim ED, Lee JY, Son JS, Byeon GJ, Yeo JS, Kim DW, et al. Guidelines for prescribing opioids for chronic non-cancer pain in Korea. Korean J Pain 2017; 30: 18-33. https://doi.org/10.3344/kjp.2017.30.1.18
  28. Kahan M, Wilson L, Mailis-Gagnon A, Srivastava A; National Opioid Use Guideline Group. Canadian guideline for safe and effective use of opioids for chronic noncancer pain: clinical summary for family physicians. Part 2: special populations. Can Fam Physician 2011; 57: 1269-76, e419-28.
  29. Woo A, Lechner B, Fu T, Wong CS, Chiu N, Lam H, et al. Cut points for mild, moderate, and severe pain among cancer and non-cancer patients: a literature review. Ann Palliat Med 2015; 4: 176-83.

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