Abstract:
BACKGROUND: Pain after spinal cord injury (SCI) is debilitating and has been reported to be
difficult to treat, despite pharmacological interventions. Pain medication misuse (PMM)
and associated individual factors among people with spinal cord injury (PWSCI) are
scarce.
AIM: To determine PMM and the associated factors in PWSCI.
SETTING: Homes of community-dwelling manual wheelchair users with SCI in South Africa.
METHODS: Community-dwelling PWSCI (n = 122) were consecutively sampled and the Pain
Medication Questionnaire (PMQ) was used to determine PMM. Descriptive statistics, Fisher’s
exact test, independent t-tests, and simple linear regression tests were performed using SPSS
v27. Testing was conducted at the 0.05 level of significance.
RESULTS: Eighty-five per cent of the participants reported the presence of pain and 48.1% of
them used pain medication. Forty-four percent of people who used pain medication scored
≥ 30, indicative of serious aberrant drug-taking behaviours. Opioids were mainly used for
neuropathic pain and in combination with other types of medications such as anticonvulsants
and non-steroidal anti-inflammatories (44.0%). Pain severity and the type of pain medication
were found to be predictors of PMM (p < 0.01 respectively).
CONCLUSION: Pain relief after SCI remains difficult to achieve, with an evident high risk of
PMM, which may lead to long-lasting side effects, dependency, or overdose.
CONTRIBUTION: This study has shown the need for the assessment of the potential risk of
dependency before prescribing pain medication, particularly opioids to PWSCI.
