Sickle Cell Pain and Sadness

Researchers from Johns Hopkins University School of Medicine report the discovery of an association between negative emotions and elevated opioid use among patients with sickle cell disease who otherwise reported low levels of pain. Sickle cell disease is an inherited condition characterized by misshapen red blood cells that congest blood vessels. Patients suffer both severe episodic pain and chronic pain. The findings derive from a small study of patient electronic data and the team cautioned that they do not infer a causal link between levels of sadness and anxiety and opioid consumption, but only an association. But, the report states, the conclusions may be useful in the pursuit of more refined definition of risk factors for abuse. The study is reported online in The Journal of Pain.

The study involved 45 patients, average age 37 years, of whom 71% were women and 93% were African American. 31 participants took long acting opioids daily, and in this cohort opioid usage increased by 3.4 morphine milligram equivalents for every 10-point increase in reported negative emotions. Study author Patrick Finan, PhD, said of the findings, “We showed that the way we think about pain is associated with opioid use even if our pain levels are low. These data argue that physicians need better communication with patients on how to take their medications from day to day to minimize fluctuations based on mood or way of thinking.” 

Read a news story about the findings.

The journal abstract may be read here.