Borderline Personality Disorder,  Medication,  Pain

Study shows trend of prescribing opioids to patients with a comorbidity of borderline personality disorder increased over time

The results also suggest that these borderline patients may be particularly sensitive to physical pain–mirroring their well-known heightened sensitivity to emotional pain.

Study shows trend of prescribing opioids to patients with a comorbidity of borderline personality disorder increased over time
January 23, 2014 | By Joe Wiegel – PCLS President

Patients with borderline personality disorder are being prescribed opioid pain medication at increasing rates according to a recent follow-up study by Drs. Frankenburg, Fitzmaurice and Zanarini.

The researchers attempted to determine the rate of use of prescription opioid medications by patients with borderline personality disorder and compare that to the rate reported by the control group during a 10-year follow-up. In addition, they attempted to determine the most clinically relevant predictors of prescription opioid use among borderline patients. They assessed the study participants at 6-year follow-up and 5 contiguous follow-up waves that were 2 years apart. All participants had a family history of psychiatric disorder assessment at the baseline as well as semi-structured interviews with proven psychometric properties including: the Medical History and Services Utilization Interview, the Structured Clinical Interview for DSM-III-R Axis I Disorders, and the Revised Family History Questionnaire.

Opioid medications are highly effective pain-relieving agents, but they have risks, including addiction, diversion, and lethality in overdose. In 2008, opioid medications accounted for 75 percent of prescription drug overdose deaths and between 1999 and 2008, opioid medication related sales, substance abuse admissions, and overdose death rates all roughly quadrupled.1 Further, urine toxicology testing revealed that addiction rates are higher in patients with a history of substance abuse, comorbid mental illness, psychosomatic tendencies, or if the patient is young and female.2 Clinical experience suggests that patients with borderline personality disorder have a complex relationship to pain, often inflicting pain on themselves, while also often seeming intolerant of chronic pain.3 It has also been noted that roughly 30 percent of patients with chronic pain may also have comorbid borderline personality disorder.


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