The Burden of Long-Term Opioid Use on Emotional, Cognitive and Sensorimotor Domains in Chronic Back Pain

This study examines cognitive, emotional, sensory, and motor function in patients with chronic back pain (CBP) with and without long-term opioid exposure (CBP+O vs. CBP-O) and the influence of race and sex on these outcomes. We recruited 64 CBP+O (mean 7.4 years of opioid use) and 64 matched CBP-O. We collected pain intensity, pain duration, NIH Toolbox outcomes, and measures of opioid use: dosage, duration, blood levels, and withdrawal symptoms. We compared both groups to a normative sample, examined sex and race influences separately, and related CBP+Os NIH Toolbox outcomes to their opioid use measures. CBP+O reported greater pain interference and poorer emotional function. Sex moderated opioid exposures effects on cognitive performance and social satisfaction, while race moderated motor dexterity and taste outcomes. In CBP+O, 1) opioid dosage was associated with cognitive speed and sensory performance; 2) blood levels of opioids corresponded with poorer attention, motor endurance, and more severe stress and negative affect; 3) opioid use duration was related to improved working memory; while 4) higher withdrawal symptoms were associated with poorer cognitive performance, worsened negative emotions, and decreased grip strength. The study demonstrates both positive and negative outcomes associated with long-term opioid use in CBP, highlighting the need to consider sex- and race-related factors when assessing function in this population.