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Reasons for Opioid Use Among Patients with Dependence on Prescription Opioids: The Role of Chronic Pain.

Journal of Substance Abuse Treatment 2014;47(2):140-145. [doi: 10.1016/j.jsat.2014.03.004]

Roger D. Weiss, MD (McLean Hospital, NEC Node), Jennifer Sharpe Potter, PhD, MPH (McLean Hospital, NEC Node), Margaret L. Griffin, PhD (McLean Hospital, NEC Node), R. Kathryn McHugh, PhD (McLean Hospital, NEC Node), Deborah L. Haller, PhD (Columbia University College of Physicians and Surgeons, GNY Node), Petra Jacobs, MD (Center for the Clinical Trials Network, NIDA), John G. Gardin, II, PhD (ADAPT, Inc., WS Node), Daniel Fischer, MEd (CASAA, University of New Mexico, SW Node), Kristen D. Rosen, MPH (University of Texas, TX Node).

The number of individuals seeking treatment for prescription opioid dependence has increased dramatically, fostering a need for research on this population. The aim of this study was to examine reasons for prescription opioid use among 653 participants with and without chronic pain, enrolled in National Drug Abuse Treatment Clinical Trials Network protocol CTN-0030, Prescription Opiate Abuse Treatment Study (POATS), a randomized controlled trial of treatment for prescription opioid dependence.

Participants identified initial and current reasons for opioid use. Participants with chronic pain were more likely to report pain as their primary initial reasons for use -- over 80% of those with chronic pain and 49% of those without it reported that pain relief was their primary reason for initiating opioid use. Participants without chronic pain were significantly more likely than those with chronic pain to report that their reason for initiating use was to get high (39% vs. 13%). Other reasons for initiating use (e.g., to improve sleep or reduce anxiety) were relatively uncommon in both groups. In terms of current reasons for opioid use, participants with chronic pain rated using opioids to cope with physical pain as more important, and using opioids in response to social interactions and craving as less important, than those without chronic pain. However, avoiding withdrawal was rated as the most important reason for current prescription opioid use, regardless of chronic pain status.

Conclusions: These findings highlight the important role of physical pain in both the initiation and maintenance of prescription opioid use in patients with chronic pain. The finding that avoidance of withdrawal was the most important reason for current use is consistent with the key role that physical dependence plays in maintaining opioid dependence. Incorporating pain-focused content and referral for pain evaluation as part of standard treatments for opioid dependence may benefit patients with co-occurring chronic pain. (Article (Peer-Reviewed), PDF, English, 2014)

Keywords: Co-occurring disorders | CTN platform/ancillary study | Opioid dependence | Pain management | Pharmacological therapy | Prescription-type opiates | Journal of Substance Abuse Treatment (journal)

Document No: 1057, PMID: 24814051, PMCID: PMC4074437.

Submitted by CTN Dissemination Librarians, 4/13/2014

Fischer, Daniel search mail
Gardin, John G. II search mail
Griffin, Margaret L. search
Haller, Debora L. search mail
McHugh, R. Kathyrn search mail
Jacobs, Petra search mail
Potter, Jennifer Sharpe search mail
Rosen, Kristen D. search
Weiss, Roger D. search mail
NIDA-CTN-0030 search www
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