Risk of Opioid Abuse and Biopsychosocial Characteristics associated with this Risk among Chronic Pain Patients attending a Multidisciplinary Pain Treatment Facility.

TitleRisk of Opioid Abuse and Biopsychosocial Characteristics associated with this Risk among Chronic Pain Patients attending a Multidisciplinary Pain Treatment Facility.
Publication TypeJournal Article
Year of Publication2015
AuthorsM Pagé G, Saïdi H, Ware MA, Choinière M
JournalClin J Pain
Date Published2015 Dec 14
ISSN1536-5409
KeywordsQuebec Pain Registry
Abstract

OBJECTIVES: The objectives of this study were to (1) determine the proportion of patients referred to a multidisciplinary pain treatment facility (MPFT) at risk of opioid abuse; (2) examine biopsychosocial factors associated with this risk; and (3) compare patient outcomes 6 months later across risk of opioid abuse and type of treatment (opioids vs. no opioids).

METHODS: Participants were 3040 patients (mean age=53.3±14.7 y; female=56%) enrolled in the Quebec Pain Registry between July 2012 and May 2014. Patients answered self-report and nurse-administered questionnaires (pain and psychosocial constructs, Opioid Risk Tool, pain medication, etc.) before initiating treatment at the MPFT and six months later. Data was analyzed using Pearson chi-square tests, multivariable binary logistic regression and multivariate general linear model.

RESULTS: Results showed that 81%, 13%, and 6% of patients were at low, moderate and severe risk of opioid abuse, respectively. Civil status, pain duration, mental health-related quality of life, and cigarette smokingwere significantly associated with risk of opioid abuse (P<0.001). There was a significant interaction between risk of opioid abuse and type of treatment in predicting 6-month pain outcomes and quality of life.

DISCUSSION: Almost 20% of patients had a moderate/severe risk of opioid abuse; whether these patients were taking opioids or not for their pain, they had worse outcomes at follow-up. These results point to the importance of assessing risk of opioid abuse in chronic pain patients and to consider how this risk may impact on their clinical evolution.

DOI10.1097/AJP.0000000000000337
Alternate JournalClin J Pain
PubMed ID26670615