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The misuse of prescription pain medication and borderline personality symptomatology

Randy A. Sansone, MD, Daron A. Watts, MD, Michael W. Wiederman, PhD


Objective: Despite the known high rates of substance misuse among individuals with borderline personality disorder (BPD), little empirical data are available regarding the explicit nature of such misuse with prescribed pain medications–the focus of the present study.

Setting: A primary care outpatient setting, with predominantly resident providers, in a midsized mid-western US city.

Patients: Consecutive outpatients who currently or have previously been prescribed pain medication (ie, lifetime pain medication exposure) (n = 185).

Main outcome measures: Relationships between BPD, according to two measures, and eight author-developed items reflecting prescription pain medication misuse.

Results: With the exception of requesting a prescription for pain medication but not having pain (n.s.), all other measures of prescription pain medication misuse were statistically significantly associated with BPD symptoms. There were also some statistically significant interactions between male gender and BPD symptoms in the prediction of pain medication misuse (ie, mixing prescribed pain medications with drugs to get high, using prescribed pain medication for recreational purposes, and selling prescribed pain medications for money).

Conclusions: Individuals with BPD are at risk for misusing prescribed pain medications, and this is especially evident regarding particular forms of misuse among men with BPD symptomatology.


borderline personality, borderline personality disorder, medication misuse, pain, pain medication, Self-Harm Inventory, substance misuse

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