Opioid withdrawal increases health risks for people who inject drugs

March 18, 2020

Experiencing the symptoms of opioid withdrawal increases the odds that a person who injects drugs will share needles or have a non-fatal overdose, according to new USC study published in the journal Drug and Alcohol Dependence.

The study has implications for others with opioid use disorder, even if they don't inject opioids, since they are also likely to experience withdrawal, putting them at higher risk for an overdose.

Opioid withdrawal symptoms can include severe pain, abdominal cramps, diarrhea, nausea and vomiting, as well as agitation and anxiety.

The study says medication-assisted treatment for opioid withdrawal is urgently needed and recommends that the drug buprenorphine be made available to those at risk. Typically prescribed by primary care physicians, buprenorphine tightly binds to opiate receptors in the brain, preventing a person from feeling the effects of the opioid, including the symptoms of withdrawal.

"Withdrawal is one of the main chronic health challenges for this population, and we need to be intervening on it," said Ricky Bluthenthal, PhD, associate dean for social justice at the Keck School of Medicine of USC and the study's lead author. "I suspect if we're successful at that, then a lot of other things that can improve health in this population will be more readily achieved."

Millions of Americans misuse opioids each year and the Centers for Disease Control and Prevention (CDC) estimates that an average of 130 people die each day from an opioid overdose. According to the CDC, needle sharing increases a person's risk of blood borne viruses such as HIV and hepatitis as well as other serious health problems.

This is the first study to report on the attributes and frequency of opioid withdrawal symptoms in a large sample of people who inject drugs. People were recruited at public places where people who use drugs congregate in San Francisco and Los Angeles.

Vast majority of study participants experienced opioid withdrawal

Of the more than 800 study participants, 85 percent reported experiencing at least one episode of opioid withdrawal in the previous six months. More than a third reported having withdrawal symptoms on a weekly basis or more. Most described their symptoms as very or extremely painful.

Researchers found any opioid withdrawal was associated with needle sharing and non-fatal overdose. People who reported having withdrawal symptoms weekly or more had even higher odds of sharing needles or overdosing than those who reported less. People who reported very severe pain from withdrawal also had higher odds of overdosing, though the severity of pain was not associated with needle sharing.

"Opioid withdrawal is a common public health issue and it is rarely treated," said Bluthenthal. "Knowing that 85% or so of the people who are chronic opiate users are going to experience withdrawal at some point in the near future and that we have medication to treat it, we should make it available for that purpose."
About this study

In addition to Bluthenthal, the study's other authors are Kelsey Simpson, Rachel Carmen Ceasar and Johnathan Zhao from the Department of Preventive Medicine, Keck School of Medicine of USC, and Lynn Wenger and Alex Kral from the Behavioral Health Research Division at RTI International.

The study was entirely supported by a federal grant RO1DA038965 from the National Institute on Drug Abuse, part of the National Institutes of Health.

Keck School of Medicine of USC

Related Pain Articles from Brightsurf:

Pain researchers get a common language to describe pain
Pain researchers around the world have agreed to classify pain in the mouth, jaw and face according to the same system.

It's not just a pain in the head -- facial pain can be a symptom of headaches too
A new study finds that up to 10% of people with headaches also have facial pain.

New opioid speeds up recovery without increasing pain sensitivity or risk of chronic pain
A new type of non-addictive opioid developed by researchers at Tulane University and the Southeast Louisiana Veterans Health Care System accelerates recovery time from pain compared to morphine without increasing pain sensitivity, according to a new study published in the Journal of Neuroinflammation.

The insular cortex processes pain and drives learning from pain
Neuroscientists at EPFL have discovered an area of the brain, the insular cortex, that processes painful experiences and thereby drives learning from aversive events.

Pain, pain go away: new tools improve students' experience of school-based vaccines
Researchers at the University of Toronto and The Hospital for Sick Children (SickKids) have teamed up with educators, public health practitioners and grade seven students in Ontario to develop and implement a new approach to delivering school-based vaccines that improves student experience.

Pain sensitization increases risk of persistent knee pain
Becoming more sensitive to pain, or pain sensitization, is an important risk factor for developing persistent knee pain in osteoarthritis (OA), according to a new study by researchers from the Université de Montréal (UdeM) School of Rehabilitation and Hôpital Maisonneuve Rosemont Research Centre (CRHMR) in collaboration with researchers at Boston University School of Medicine (BUSM).

Becoming more sensitive to pain increases the risk of knee pain not going away
A new study by researchers in Montreal and Boston looks at the role that pain plays in osteoarthritis, a disease that affects over 300 million adults worldwide.

Pain disruption therapy treats source of chronic back pain
People with treatment-resistant back pain may get significant and lasting relief with dorsal root ganglion (DRG) stimulation therapy, an innovative treatment that short-circuits pain, suggests a study presented at the ANESTHESIOLOGY® 2018 annual meeting.

Sugar pills relieve pain for chronic pain patients
Someday doctors may prescribe sugar pills for certain chronic pain patients based on their brain anatomy and psychology.

Peripheral nerve block provides some with long-lasting pain relief for severe facial pain
A new study has shown that use of peripheral nerve blocks in the treatment of Trigeminal Neuralgia (TGN) may produce long-term pain relief.

Read More: Pain News and Pain Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.