Trial reportAnesthesiology2015
Psychiatric Comorbidity Is Associated Prospectively with Diminished Opioid Analgesia and Increased Opioid Misuse in Patients with Chronic Low Back Pain.
Trial report in Anesthesiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03588806 (Use of Xtampza ER to Overcome Difficulties in Swallowing Opioid Pills), which is not on this map. Cited by 58 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Use of Xtampza ER to Overcome Difficulties in Swallowing Opioid Pills
Who cites it
58 citing papers in PubMed, 2 syntheses or guidelines pooled it, 134 citations in OpenAlex.
- Multimorbidity and analgesic-related harms: a systematic review.British journal of anaesthesia · 2025Pooled it
- Brief Mindfulness-Based Interventions for Acute and Chronic Pain: A Systematic Review.Journal of alternative and complementary medicine (New York, N.Y.) · 2019Pooled it
- Mindfulness-Oriented Recovery Enhancement vs Supportive Group Therapy for Co-occurring Opioid Misuse and Chronic Pain in Primary Care: A Randomized Clinical Trial.JAMA internal medicine · 2022Trial
- Opioid Exposure Negatively Affects Antidepressant Response to Venlafaxine in Older Adults with Chronic Low Back Pain and Depression.Pain medicine (Malden, Mass.) · 2020Trial
- Trial
- Self-reported cumulative medical opioid exposure and subjective responses on first use of opioids predict analgesic and subjective responses to placebo-controlled opioid administration.Regional anesthesia and pain medicine · 2019Trial
- Endogenous Opioid Function and Responses to Morphine: The Moderating Effects of Anger Expressiveness.The journal of pain · 2017Trial
- Prediction of response to tapentadol in chronic low back pain.European journal of pain (London, England) · 2017Trial
- Trial
- Opioid Craving in Chronic Pain Management: A Structural Equation Model of Veterans in Pain Rehabilitation.Military medicine · 2026Observational
- Nonpharmacological and pharmacological influences on opioid effects: A review of clinical research findings.The Journal of pharmacology and experimental therapeutics · 2025Review
- Co-prescribing of antidepressants and opioids for non-cancer pain in England, 2010-2019: a descriptive study using CPRD primary care electronic health records.BMC primary care · 2025Article
- Psychiatric Comorbidity Does Not Enhance Prescription Opioid Use in Inflammatory Bowel Disease as It Does in the General Population.Inflammatory bowel diseases · 2025Article
- A multisite validation of brain white matter pathways of resilience to chronic back pain.eLife · 2024Article
- Fibromyalgia pain management effectiveness from the patient perspective: a qualitative evidence synthesis.Disability and rehabilitation · 2024Review
- Brain white matter pathways of resilience to chronic back pain: a multisite validation.bioRxiv : the preprint server for biology · 2024Article
- Affective neuroscience personality traits in opioid use disorder patients: The relationship with earlier onset of substance use, the severity of addiction, and motivational factors to quit opiate use.Brain and behavior · 2024Article
- Targeting Prefrontal Cortex Dysfunction in Pain.The Journal of pharmacology and experimental therapeutics · 2024Review
- Covariate Adjustment in Chronic Pain Trials: An Oft-Missed Opportunity.The journal of pain · 2023Review
- Back Pain Consortium (BACPAC): Protocol and Pilot Study Results for a Randomized Comparative-Effectiveness Trial of Antidepressants, Fear Avoidance Rehabilitation, or the Combination for Chronic Low Back Pain and Comorbid High Negative Affect.Pain medicine (Malden, Mass.) · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundOpioids are frequently prescribed for chronic low back pain (CLBP), but there are little prospective data on which patient subgroups may benefit. Psychiatric comorbidity, such as high levels of depression and anxiety symptoms (termed comorbid negative affect [NA]), is a common presentation and may predict diminished opioid analgesia and/or increased opioid misuse.
methodsThe authors conducted a 6½-month prospective cohort study of oral opioid therapy, with an active drug/placebo run-in period, in 81 CLBP patients with low, moderate, and high levels of NA. Treatment included an opioid titration phase with a prescribing physician blinded to NA group assignment and a 4-month continuation phase, during which subjects recorded daily pain levels using an electronic diary. The primary outcome was the percent improvement in average daily pain, summarized weekly.
resultsThere was an overall 25% dropout rate. Despite the high NA group being prescribed a higher average daily dose of morphine equivalents, linear mixed model analysis revealed that the 24 study completers in each of the high NA and low NA groups had an average 21 versus 39% improvement in pain, respectively (P < 0.01). The high NA group also had a significantly greater rate of opioid misuse (39 vs. 8%, P < 0.05) and significantly more and intense opioid side effects (P < 0.01).
conclusionsThese results indicate that the benefit and risk considerations in CLBP patients with high NA versus low NA are distinctly different. Thus, NA is an important phenotypic variable to characterize at baseline, before deciding whether to prescribe opioids for CLBP.
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