Soteria Screening


Chronic Back Pain Linked to Illicit Drug Use

In a recent study, the results of which should surprise absolutely no one, chronic lower back pain sufferers are more likely to turn to illicit drugs like cocaine, heroin, marijuana, and methamphetamines for relief. Investigators admit that the relationship between the two is a premature connection at best that warrants further investigation, but the connection has been made nonetheless.

Anna Shmagel, a doctor and the first author of the study that was published in Spine, notes that there are several ways in which these results can be interpreted. For one thing, illicit drug use may come first in a "chicken or the egg" type of situation and may therefore make chronic pain worse. Or, similarly, drug users who are already addicted may claim to have chronic back pain in order to obtain prescriptions from their doctors that will give them access to prescription narcotics, like opiates.

Just as likely are the odds that those who are suffering with chronic pain are turning to illicit drugs in order to self-medicate. Another possibility, notes Shmagel, is the idea that chronic back pain and drug use have side effects in common, such as depression. What this translates to is that if someone with chronic back pain becomes depressed, he or she may turn to drugs for comfort. Conversely, if someone is depressed because he or she is a chronic drug user, then the cycle perpetuates itself as the user looks for more and more drugs in an attempt to feel better.

The study to which Shmagel was a party collected responses to back pain-related questions and drug use-related questions from 5,000 adults aged 20 to 69 years old who identified themselves as chronic lower back pain sufferers. For the purposes of the study, "chronic" back pain was defined as that which was present for three months or more. Investigators compared their answers to the answers of those who did not suffer from chronic lower back pain.

Their findings ultimately showed that nearly 47 percent of people with chronic lower back pain turned to marijuana for relief, compared to 42 percent who used marijuana but did not suffer from chronic pain. 22 percent self-medicated with cocaine, compared to the 14 percent who used without pain. Methamphetamines and heroin came in last place, ironically, with nearly ten percent of the adults choosing meth for their pain (compare to five percent of adults without pain), and five percent choosing heroin (over only two percent of adults without pain).

Perhaps one of the most telling results of the survey was that adults who had both chronic lower back pain and chronic illicit drug use (about 22 percent) were more likely to have an active prescription for opiates, compared to those who did not have a history of illicit drug use (about 15 percent). Similarly, nearly 26 percent of those suffering with pain had an active prescription for opioid analgesics, compared to nearly 18 percent of those who were not suffering without pain who had similar prescriptions.

Shmagel and her colleagues summed up the survey by noting that despite limitations like not including individuals who were institutionalized, the survey still paints a clear picture of the drug abuse problem that currently exists in the United States among those who are suffering from chronic lower back pain and feel they have nowhere else to turn but to illicit drugs.