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Characterizing chronic pain in late adolescence and early adulthood

prescription opioids, marijuana use, obesity, and predictors for greater pain interference

Anastas, Tracya; Colpitts, Kelseyb; Ziadni, Maisac,*; Darnall, Beth D.c; Wilson, Anna C.b

doi: 10.1097/PR9.0000000000000700
Pediatric: PDF Only

Introduction: Chronic pain in late adolescence and young adults is understudied and poorly characterized.

Objectives: We sought to characterize key variables that may impact pain interference in late adolescents and young adults with chronic pain, including prescription opioid use, marijuana use, psychological symptoms, and obesity.

Methods: Retrospective, cross-sectional medical chart review for patients aged 17 to 23 years (N = 283; 61% Females) seeking care at a tertiary care pain clinic. Data on pain characteristics, health behaviors, and mental health distress were examined, in addition to self-reported pain intensity and interference.

Results: Overlapping pain conditions were common in this young adult sample (mean ≥ 2 pain conditions). Back pain was the most commonly cited pain condition, and the majority of pain was of unknown etiology. Results revealed high rates for current opioid prescription, overweight or obese status, and mental health problems. Those using prescription opioids were more likely to endorse tobacco use and had greater pain interference. Importantly, the presence of mental health distress and opioid use were predictive of higher levels of pain-related interference.

Conclusion: Treatment-seeking adolescents and young adults with chronic pain evidence complex care needs that include pain and mental comorbidities, as well as risky health behaviors. Pain and mental health distress were associated with poorer physical health, opioid prescription and marijuana use, and pain-related interference. Findings underscore the need for additional research on pain, treatment patterns, and health behaviors and their impact on developmental trajectories, as well as the need to develop and apply effective early interventions in this at-risk population.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

aDepartment of Psychology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, IN, USA

bDepartment of Pediatrics, Institute on Development & Disability, Oregon Health & Science University, Portland, OR, USA

cDepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, USA

Corresponding author. Address: Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, 1070 Arastradero Rd, Suite 200, MC5596, Palo Alto, CA 94304. Tel.: (650) 736 5494. E-mail address: mziadni@stanford.edu (M. Ziadni).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Received June 18, 2018

Received in revised form September 24, 2018

Accepted October 01, 2018

© 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.