Abstract
Background
Interpersonal abuse is associated with clinical problems including chronic pain disorders.
Objectives
The objective of this study is to describe 30-day and lifetime prevalence of emotional, physical, and sexual abuse found in men and women prescribed opioids for chronic pain.
Design
Cross-sectional interview is the design of this study.
Participants
Patients, 1,009, currently prescribed opioids for chronic noncancer pain. They were recruited from the practices of 235 Family Physicians and Internists in Wisconsin. The most common pain diagnoses were arthritis, low back pain, headache, and fibromyalgia/myofascial pain.
Measurement
Data for this secondary analysis on rates of interpersonal abuse were based on 3 questions from the Addiction Severity Index (ASI) regarding 30-day and lifetime emotional, physical, and sexual abuse.
Results
Forty-seven percent of women and 22% of men reported a history of lifetime physical abuse. Thirty -five percent of women and 10% of men reported lifetime sexual abuse. Binary logistic regression identified the following variables associated with lifetime physical abuse: female gender (RR 2.81, CI 2.01–3.94), age 31–50 (RR1.77, CI 1.30–2.41), Caucasian (RR1.67, CI 1.19–2.35), increased psychiatric symptoms as measured by the ASI (RR 2.14, CI 1.56–2.94), and lifetime suicide attempts (RR 3.98, CI 2.76–5.74).
Conclusions
This study reports prevalence of abuse in both men and women prescribed opioids for chronic pain in primary care settings. Subjects who report experiencing interpersonal abuse also report significantly higher rates of suicide attempts and score higher on the ASI psychiatric scale. Screening patients taking opioids for chronic pain for interpersonal abuse may lead to a better understanding of contributors to their physical and mental health.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Tjaden P, Thoennes N. Prevalence and consequences of male-to-female and female-to-male intimate partner violence as measured by the national violence against women survey. Violence Against Women. 2000;6(2):142–61.
Hamberger LK, Saunders DG, Hovey M. Prevalence of domestic violence in community practice and rate of physician inquiry. Fam Med. 1992 May–Jun;24(4):283–7.
Kramer A, Lorenzon D, Mueller G. Prevalence of intimate partner violence and health implications for women using emergency departments and primary care clinics. Womens Health Issues. 2004 Jan–Feb;14(1):19–29.
Coker AL, Smith PH, Bethea L, King MR, McKeown RE. Physical health consequences of physical and psychological intimate partner violence. Arch Fam Med. 2000 May;9(5):451–7.
Dube SR, Anda RF, Felitti VJ, Chapman DP, Williamson DF, Giles WH. Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span—findings from the adverse childhood experiences study. JAMA. 2001 DEC 26;286(24):3089–96.
Abbott J, Johnson R, Koziol-McLain J, Lowenstein SR. Domestic violence against women. Incidence and prevalence in an emergency department population. JAMA. 1995 Jun 14;273(22):1763–7.
McCauley J, Kern DE, Kolodner K, et al. The “battering syndrome”: Prevalence and clinical characteristics of domestic violence in primary care internal medicine practices. Ann Intern Med. 1995 Nov 15;123(10):737–46.
Coker AL, Davis KE, Arias I, et al. Physical and mental health effects of intimate partner violence for men and women. Am J Prev Med. 2002 Nov;23(4):260–8.
Finestone HM, Stenn P, Davies F, Stalker C, Fry R, Koumanis J. Chronic pain and health care utilization in women with a history of childhood sexual abuse. Child Abuse Negl. 2000 Apr;24(4):547–56.
Plichta SB. Intimate partner violence and physical health consequences—policy and practice implications. J Interpers Violence. 2004 NOV;19(11):1296–323.
Dienemann J, Boyle E, Baker D, Resnick W, Wiederhorn N, Campbell J. Intimate partner abuse among women diagnosed with depression. Issues Ment Health Nurs. 2000 Jul–Aug;21(5):499–513.
Campbell JC. Health consequences of intimate partner violence. Lancet. 2002 Apr 13;359(9314):1331–6.
Leserman J. Sexual abuse history: prevalence, health effects, mediators, and psychological treatment. Psychosom Med. 2005 Nov–Dec;67(6):906–15.
Campbell J, Jones AS, Dienemann J, et al. Intimate partner violence and physical health consequences. Arch Intern Med. 2002 May 27;162(10):1157–63.
Rubin JJ. Psychosomatic pain: new insights and management strategies. South Med J. 2005 NOV;98(11):1099–110.
Goldberg RT, Pachas WN, Keith D. Relationship between traumatic events in childhood and chronic pain. Disabil Rehabil. 1999 Jan;21(1):23–30.
Davis DA, Luecken LJ, Zautra AJ. Are reports of childhood abuse related to the experience of chronic pain in adulthood? A meta-analytic review of the literature. Clin J Pain. 2005 Sep–Oct;21(5):398–405.
Varjavand N, Cohen DG, Novack DH. An assessment of residents’ abilities to detect and manage domestic violence. J Gen Intern Med. 2002 Jun;17(6):465–8.
McLellan AT, Kushner H, Metzger D, et al. The fifth edition of the addiction severity index. J Subst Abuse Treat. 1992;9(3):199–213.
Miele GM, Carpenter KM, Smith Cockerham M, Dietz Trautman K, Blaine J, Hasin DS. Concurrent and predictive validity of the substance dependence severity scale (SDSS). Drug Alcohol Depend. 2000 Apr 1;59(1):77–88.
Horowitz M, Wilner N, Alvarez W. Impact of event scale: a measure of subjective stress. Psychosom Med. 1979 May;41(3):209–18.
Sundin EC, Horowitz MJ. Impact of event scale: psychometric properties. Br J Psychiatry. 2002 Mar;180:205–9.
Fleming MF, Balousek SL, Klessig CL, Mundt MP, Brown DD. Substance use disorders in a primary care sample receiving daily opioid therapy. J Pain. 2007 May 10; PMID: 17499555 (in press).
Coker AL. Preventing intimate partner violence: how we will rise to this challenge. Am J Prev Med. 2006 Jun;30(6):528–9.
Acknowledgments
This work was funded by National Institute of Drug Abuse 1 R01 DA13686.
The authors would like to acknowledge Cynthia Colombo, Kimberly Bastic, Ellyn Stauffacher, Marlon Mundt, Larissa Zakletskaia, Donna Baranowski, Linda Norton, and Nicholas Di Meo, who helped conduct the study.
Conflict of Interest
None Disclosed.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Balousek, S., Plane, M.B. & Fleming, M. Prevalence of Interpersonal Abuse in Primary Care Patients Prescribed Opioids for Chronic Pain. J GEN INTERN MED 22, 1268–1273 (2007). https://doi.org/10.1007/s11606-007-0257-6
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11606-007-0257-6