Abstract: Objective: The prevalence of opioid therapy for chronic noncancer pain has increased dramatically in recent years, with a parallel increase in opioid abuse, misuse and deaths from accidental overdose. We review epidemiological and clinical data that point to the important roles psychiatric disorders have in the use and abuse of opioids in patients with chronic pain.Method: We conducted literature searches on the PubMed with the key phrases “chronic pain” and “opioid therapy” and selected those articles on the epidemiology of comorbidity between chronic pain and psychiatric disorders, the trends in long-term opioid therapy and the clinical trials that involved using opioid therapy for chronic pain or for mental health disorders.

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In a recently published paper in General Hospital Psychiatry , we described the association between a diagnosis of a serious mental illness and a chronic pain condition. In a national sample of all patients who utilized services from the Veterans Health Administration within a given year, those individuals with schizophrenia and bipolar disorder were significantly more likely to have a chart diagnosis of chronic pain compared to those without these psychiatric diagnoses. We concluded that this line of research has important implications for understanding how chronic pain might impact mental health recovery.

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Birgenheir et al found that a chart diagnosis of a chronic pain condition occurred approximately two times as often in veterans with a documented diagnosis of bipolar disorder compared to those without bipolar disorder. These findings are important for addressing the overall health of patients with bipolar disorder . The authors noted that the veteran population was a limitation of their study

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The term “chronic benign pain” contains a contradiction in terms. If chronic pain is debilitating enough to compel patients to seek medical relief, then it is hardly benign. Chronic “idiopathic” pain is an equally problematic term

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Eighteen states and the District of Columbia have legalized possession and use of medical marijuana. Registries from these state-approved programs suggest that up to 94% of participating patients are registered for severe or chronic pain .

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Abstract: Objective: To assess the feasibility and acceptability of routine web-based screening in general hospital settings, and describe the level of common mental disorder.Method: A service development platform to integrate mental and physical healthcare was implemented in 6 specialties (rheumatology, limb reconstruction, hepatitis C, psoriasis, adult congenital heart disease (ACHD), chronic pain) across 3 general hospitals in London, UK. Under service conditions, patients completed a web-based questionnaire comprising mental and physical patient-reported outcome measures, whilst waiting for their appointment.

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