ArticlePain and therapy2021
Psychosocial, Functional, and Emotional Correlates of Long-Term Opioid Use in Patients with Chronic Back Pain: A Cross-Sectional Case-Control Study.
Article in Pain and therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- A Systematic Review and Meta-Analysis of the Use of the National Institutes of Health Toolbox Cognition Battery in Clinical Populations.Neuropsychology review · 2026Pooled it
- Chronic Pain and Opioids in the Elderly: Treating the Brain, Not Just the Body.International journal of environmental research and public health · 2026Review
- Mental and Behavioral Health Disparities Among Pain-Reliever Misusers: A Cross-Sectional Analysis by Race and Ethnicity.Healthcare (Basel, Switzerland) · 2025Article
- Assessment of Postural Stability in Semi-Open Prisoners: A Pilot Study.Journal of clinical medicine · 2025Article
- Influence of chronic pain on regional brain volume reduction in a general older Japanese population: a longitudinal imaging analysis from the Hisayama Study.Brain communications · 2025Article
- Neuroimaging of opioid effects in humans across conditions of acute administration, chronic pain therapy, and opioid use disorder.Trends in neurosciences · 2024Review
- Article
- The Alterations in the Brain Corresponding to Low Back Pain: Recent Insights and Advances.Neural plasticity · 2024Review
- The inter-relationships of the neural basis of rumination and inhibitory control: neuroimaging-based meta-analyses.Psychoradiology · 2022Review
- Opioid Consumption in Chronic Pain Patients: Role of Perceived Injustice and Other Psychological and Socioeconomic Factors.Journal of clinical medicine · 2022Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
Abstract
introductionThe opiate epidemic has severe medical and social consequences. Opioids are commonly prescribed in patients with chronic pain, and are a main contributor to the opiate epidemic. The adverse effects of long-term opioid usage have been studied primarily in dependence/addiction disorders, but not in chronic pain. Here, we examine the added iatrogenic effects, psychology, and brain morphology of long-term opioid use in matched patients with chronic pain with and without opioid use (case-controlled design).
methodsWe compared psychosocial, functional, and psychological measures between patients with chronic back pain (CBP) who were managing their pain with or without opioids, thereby controlling for the effect of pain on these outcomes. In addition, we investigated brain morphological differences associated with long-term opioid usage. We recruited 58 patients with CBP, 29 of them on long-term opioids and 29 who did not use opioids, and who were matched in terms of age, sex, pain intensity, and pain duration. Questionnaires were used to assess pain quality, pain psychology, negative and positive emotions, physical, cognitive, sensory, and motor functions, quality of life, and personality traits.
resultsPatients with CBP on opioids displayed more negative emotion, poorer physical function, and more pain interference (p < 0.001), whereas there were no statistical differences in cognitive and motor functions and personality traits. Voxel-based morphometry using structural brain imaging data identified decreased gray matter density of the dorsal paracingulate cortex (family-wise error-corrected p < 0.05) in patients with opioids, which was associated with negative emotion (p = 0.03). Finally, a volumetric analysis of hippocampal subfields identified lower volume of the left presubiculum in patients on opioids (p < 0.001).
conclusionLong-term opioid use in chronic pain is associated with adverse negative emotion and disabilities, as well as decreased gray matter volumes of specific brain regions.
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