Psychological descriptors of excessive use of analgesic medication

Introduction. Patients suffering from migraine and tension-type-headache ar e at risk of misusing analgesics and therefore developing chronic drug-indu ced headache. The present study compares migraine patients with and without abuse to identify psychological descriptors promoting drug abuse. Methods, We examined 21 in-patients with migraine and drug-abuse and 21 out -patients with migraine and no drug-abuse who were comparable regarding age and diverse pain variables (intensity, frequency, duration, etc.). Psychom etric questionnaires measured the constructs "pain-disability", "depression ", "self-efficacy" and "pain-coping". Using a standardized interview we inv estigated the external (environment) and internal (mental factors) conditio ns of all patients during medication intake. Results. Migraineurs who misused medications showed significantly greater d isability, greater helplessness and anxiety due to pain and a tendency towa rds more marked general depression than non-abusers. The extent of the help less and depressive coping with pain was best suited for distinguishing the patients with and without drug abuse,followed by the fact that those with abuse receive drugs from several doctors at the same time and demand that t he drugs free them of all complaints. Conclusions. These findings suggest that migraine patients with drug abuse often take analgesics not according to their headache, but rather depending on certain other factors.