Pharmaceutical Opioid Use and Dependence among People Living with Chronic Pain: Associations Observed within the Pain and Opioids in Treatment (POINT) Cohort

Campbell, Gabrielle; Nielsen, Suzanne; Larance, Briony; Bruno, Raimondo; Mattick, Richard P.; Hall, Wayne; Lintzeris, Nicholas; Cohen, Milton; Smith, Kimberley J.; Degenhardt, Louisa

doi:10.1111/pme.12773

Cited by 88 publications

(82 citation statements)

References 47 publications

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“…Another consideration is that the subjects included in our analysis were all enrollees of private or employer‐based insurance plans, and they tend to have fewer complications and lower health care utilization compared with patients enrolled on publicly insured health plans . Another study on a cohort of mainly publicly insured adult patients with SCD indicated that the median dose of daily OME was 6 mg, which is similar to our observation in this study and lower than the dose used to treat other pain syndromes, such as chronic non‐cancer pain …”

Section: Discussionsupporting

confidence: 77%

Characterization of opioid use in sickle cell disease

Han

Zhou

Saraf

et al. 2017

Pharmacoepidemiology and Drug

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Section: Discussionsupporting

confidence: 77%

Characterization of opioid use in sickle cell disease

Han

Zhou

Saraf

et al. 2017

Pharmacoepidemiology and Drug

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“…A significant minority of our sample reports concurrent use of more than one opioid and many participants report that they also use OTCs. These findings are consistent with previous findings of opioid use in other chronic pain patients [55]. Similar to other pain conditions, the unemployed [41,56] and older individuals [57,58] were more likely to report opioid use.…”

Section: Physical and Psychological Burden In Opioid Userssupporting

confidence: 83%

Survey of Pain Therapies in Marfan Syndrome

Speed¹

2017

J Musculoskelet Disord Treat

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Objective: Pain in Marfan syndrome is common, although frequently under diagnosed and undertreated. Few studies have investigated the treatment of pain symptoms in Marfan syndrome and no study has reported on the use of opioid therapy in this patient population. This study aims to characterize the use of pain treatment interventions, including opioid use in individuals with Marfan syndrome. We hypothesize that opioid use would be associated with worse pain and greater psychological burden and that pain-related disability would moderate opioid use.Methods: Individuals with Marfan syndrome completed an online questionnaire assessing pain severity, psychological burden, and pain management therapies. The sample reporting pain (N = 218) were 74.5% female, average age ranging from 35 to 44 years, predominantly white (91%), and majority are employed (53%).Results: Participants frequently use a combination of pharmacological and non-pharmacological therapies, and the most commonly used treatments are over the counter medications and opioid medications. Use of opioids, and non-opioid medications, but not non-pharmacological treatments, increases with pain severity. Individuals who use opioids (34%) report more severe and frequent pain compared to non-opioid users, perceive greater pain-related disability and psychological burden, and more frequently utilize the emergency department. Conclusion:Pharmacological and non-pharmacological treatment for pain in Marfan syndrome is common, although psychotherapeutic interventions are significantly underutilized. Further studies are needed to address pain management in Marfan syndrome. Pain therapies should be multimodal and include adjunctive interventions that reduce pain and suffering, improve function, and enhance quality of life in this patient population.

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“…For example, data from the United States suggest that the non-medical use of prescription opioids is most common among younger people [41]. In Australia, younger males have been identified as most at risk of developing opioid dependence among people prescribed opioids for chronic pain [42]. Furthermore, unintentional deaths due to oxycodone toxicity are higher among males between the ages of 35 and 44 [43].…”

Section: Discussionmentioning

confidence: 99%

Initiation of strong prescription opioids in Australia: cohort characteristics and factors associated with the type of opioid initiated

Gisev¹,

Pearson²,

Blanch

et al. 2016

Brit J Clinical Pharma

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AIMSTo describe the characteristics of Australians initiating strong opioids and examine the factors associated with the type of opioid initiated. METHODSPharmaceutical Benefits Scheme dispensing records were extracted for a 10% sample of people who initiated a strong opioid treatment episode (buprenorphine, fentanyl, hydromorphone, morphine, oxycodone) between 29 September 2009 and 31 December 2013, as evidenced by the absence of a strong opioid dispensing for at least 90 days. The cohort was restricted to people with complete medicines ascertainment. Socio-demographic characteristics, previous dispensing histories and index opioid use were examined. Multinomial logistic regression was used to calculate adjusted relative risk ratios (aRRRs) and 95% confidence intervals (CIs) to determine the factors associated with the type of opioid medicine initiated, relative to oxycodone. RESULTSThe cohort consisted of 125 335 people: 58.3% were female and 63.7% were aged ≥65 years. The most commonly initiated strong opioid was oxycodone (72.8%), usually 5 mg immediate-release tablets (76.1%). Compared to people aged 18-44 years, those ≥85 years were 14.18 times as likely (95% CI 12.67-15.87) to initiate morphine than oxycodone. Compared to people without a cancer treatment history, those with a cancer treatment history were 2.34 times as likely (95% CI 2.11-2.60) to initiate morphine than oxycodone. CONCLUSIONSThe most commonly initiated strong opioid was oxycodone, usually at lower strengths. Those who initiated oxycodone were more likely to be younger with no previous cancer treatment history. As these are high-risk characteristics for potential harms, a judicious approach when initiating strong opioids for this group is necessary.

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Pharmaceutical Opioid Use and Dependence among People Living with Chronic Pain: Associations Observed within the Pain and Opioids in Treatment (POINT) Cohort

Abstract: In this population of people taking opioids for CNCP, consumption of higher doses was associated with increased risk of problematic behaviors, and was more likely among people with a complex profile of physical and mental health problems.

Cited by 88 publications

References 47 publications

Characterization of opioid use in sickle cell disease

Characterization of opioid use in sickle cell disease

Survey of Pain Therapies in Marfan Syndrome

Initiation of strong prescription opioids in Australia: cohort characteristics and factors associated with the type of opioid initiated

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