To better understand the most common and challenging side effect of opioid therapy, opioid-induced constipation (OIC), PainPathways asked readers to share their experiences. Overall, responses were consistent with previous findings on OIC in chronic non-cancer pain patients, with more women than men responding. Work is underway by Editor-in-Chief and World Institute of Pain President Richard Rauck, MD, to further explore the important survey results below for scientific publication.
Lower the Barrier: Talk Early & Often to Overcome Embarrassment
Responses indicate that early and ongoing conversations about OIC are key to patient satisfaction and effective OIC management. Readers reported more than 1/3 of the prescribing physicians failed to discuss OIC as a side effect, while nearly 80 percent of respondents said they were not comfortable talking to their doctor about OIC. Readers reported that stumbling blocks include embarrassment about OIC and their physician’s reluctance to discuss the risk of OIC, address GI symptoms in follow-up visits, and a feeling that their physician did not understand OIC and how to manage it. Respondents also attributed reluctance to discuss OIC during follow-up visits to their doctors’ reluctance to discuss OIC in initial and previous encounters.
OIC Forces Patients to Stop Opioid Therapy
Nearly 60 percent of readers reported taking less opioids or stopping use due to side effects. Of these, 90 percent report they did so because of OIC. Additional side effects mentioned were sedation (22.27 percent), nausea and vomiting (26.36 percent) and other (20.45 percent). The majority of other respondents who decreased or stop using opioids named the fear of dependence or fear of becoming addicted.
Sex, Diet & Depression
Unlike the standard Patient Assessment of Constipation–Quality of Life (PAC-QOL) questionnaire tool used by physicians, this survey asked about sexual intimacy and dietary choices and found them of significance with OIC. Current OIC literature reports depression in OIC patients across demo-graphic groups at 11-19 percent. Surprisingly, this survey shows depression is more prevalent than previously thought, at 48.5percent. Readers also reported embarrassment, low self-esteem, social isolation, anger, frustration and irritability in relation to OIC. Learn more about OIC at velaharbor.com/opioid-induced-constipation.
PainPathways is the first, only and ultimate pain magazine. First published in spring 2008, PainPathways is the culmination of the vision of Richard L. Rauck, MD, to provide a shared resource for people living with and caring for others in pain. This quarterly resource not only provides in-depth information on current treatments, therapies and research studies but also connects people who live with pain, both personally and professionally.