Substance use histories in patients seeking treatment for controlled-release oxycodone dependence

Potter, Jennifer Sharpe; Hennessy, Grace; Borrow, Jennifer; Greenfield, Shelly F.; Weiss, Roger D.

doi:10.1016/j.drugalcdep.2004.05.001

Cited by 54 publications

(29 citation statements)

References 9 publications

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Section: Discussioncontrasting

confidence: 99%

“…Patients with severe chronic pain (a score of ≥7 on a 1-10 point scale) had greater depressive symptom severity and a greater probability of occupational disability than those patients with mild to moderate chronic pain or no chronic pain; depressive symptoms and being on disability are both associated with a greater likelihood of relapse to opioid use 7 . In contrast to previous reports 1, [14][15][16] , no differences were observed between individuals with and without severe chronic pain with regard to substance use histories.Our results suggest that in SUD treatment settings, in which pain is common, the presence of severe pain may be a clinically meaningful cutoff point when considering the clinical impact of chronic pain on other aspects of SUD treatment. Rapid screening is not a substitute for comprehensive pain assessment; rather, it provides a signal of the negative impact of pain on social and occupational functioning.…”

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confidence: 99%

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Chronic Pain Severity in Opioid-Dependent Patients

Potter¹,

Shiffman²,

Weiss³

2008

The American Journal of Drug and Alcohol Abuse

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Treatment-seeking opioid dependent patients present frequently with chronic pain (CP). This pilot study examined the feasibility and utility of a single-item rapid screening tool for identifying CP with implications for SUD treatment in a sample of patients presenting for inpatient opioid detoxification (n=110). Most respondents (91.2%) reported pain in the past week. Forty-seven (42.8%) had CP. Individuals with severe CP had significantly greater depressive symptom severity, pain-related functional interference, and were more likely to be on disability than individuals with mild to moderate CP or no CP. The relationships were supported in a multivariate model. The results suggest it is feasible and important to assess for CP severity in SUD treatment settings. Keywords chronic pain; opioid dependence; assessmentPatients with opioid use disorders present frequently present with chronic pain (CP). These patients are more likely to have higher rates of psychosocial stressors than their non-pain counterparts, which places them at greater risk for difficulties with their substance use disorder 1, 2 . Because pain is common in SUD populations, clinicians would benefit from an efficient and clinically meaningful method to identify those patients whose pain warrants direct attention in their SUD treatment.In pain clinics, where pain is typically the reason for seeking treatment, assessment of chronic pain includes information regarding pain severity and pain-related functional interference 3 . Pain-related functional interference is associated disproportionately with increased pain severity, with greater interference most likely when pain severity is moderate or greater. When assessing cancer and chronic pain, categorizing the level of pain as mild (1-4), moderate (5-6), or severe (7-10) on a 10-point numeric rating scale provides a simple, reliable, and valid method for communicating with patients about pain and guiding pain-related treatment decisions 4-6 .In contrast, there has been relatively little research regarding the assessment of chronic pain and its severity among patients with co-occurring SUD. In SUD treatment, pain is not generally the primary focus of treatment. Thus, in addition to categorizing pain, clinicians must determine the extent to which pain may be relevant to the SUD. One approach is to determine the extent to which pain is associated with other factors that may affect the likelihood of continued substance use or relapse (e.g. psychosocial stressors) 7 . The purpose of this pilot study was to examine the feasibility and utility of a single-item rapid screening METHODSParticipants were 110 opioid-dependent adults, age 18 or older, admitted for detoxification to one of three inpatient units in Massachusetts. Participants were excluded if they were unable to provide informed consent due to cognitive impairment, psychiatric instability, or language barrier. After receiving approval from the McLean Hospital Institutional Review Board, the authors obtained written informed consent and admin...

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Section: Discussioncontrasting

confidence: 99%

contrasting

confidence: 99%

Chronic Pain Severity in Opioid-Dependent Patients

Potter¹,

Shiffman²,

Weiss³

2008

The American Journal of Drug and Alcohol Abuse

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“…Oxycodone is widely prescribed for pain management, yet there is increasing evidence of its high abuse potential (Cicero et al 2005;Miller and Greenfeld 2004;Potter et al 2004). This is an important point to take into account when considering oxycodone as an analgesic treatment, as certain risk factors can increase an individual's susceptibility to developing an addiction to this drug.…”

Section: Discussionmentioning

confidence: 99%

The effects of a single exposure to uncontrollable stress on the subsequent conditioned place preference responses to oxycodone, cocaine, and ethanol in rats

et al. 2007

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“…A particularly common pattern of multiple drug use among methadone patients is the ingestion of large doses of a rapid-onset benzodiazepine, such as diazepam, immediately before or after the daily methadone dose. Patients have reported that this practice "boosts" the methadone and creates a "high" that does not occur if the methadone is taken alone [32]. Given the substantial rates of polydrug use, it is not surprising that 26% to 38% of nonmedical users of opioid analgesics, stimulants or tranquilizers met criteria for abuse or dependence.…”

Section: Discussionmentioning

confidence: 94%

Nonmedical use and abuse of scheduled medications prescribed for pain, pain-related symptoms, and psychiatric disorders: Patterns, user characteristics, and management options

Smith

Woody²

2005

Curr Psychiatry Rep

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The nonmedical use of scheduled medications commonly prescribed for pain, pain-related symptoms, and psychiatric disorders began rising in the mid-1990s. Physicians are confronted with the dilemma of how to minimize the abuse and diversion potential of these products without compromising access for patients with a legitimate medical need. Using data from the National Survey on Drug Use and Health, we describe the scope of nonmedical use of opioids, stimulants, and tranquilizers; characteristics of nonmedical users; and options available to reduce abuse liability. In 2003, lifetime prevalence estimates of nonmedical use were 31.2 million for opioids, 20.7 million for stimulants, and 20.2 million for tranquilizers. Nonmedical users of psychotherapeutics were more likely to be Caucasian; use alcohol, cocaine, or heroin; and to use needles to inject drugs than those who reported using illicit drugs only. Sources of diversion are enumerated, and options for minimizing the abuse liability associated with these medications are described.

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Substance use histories in patients seeking treatment for controlled-release oxycodone dependence

Cited by 54 publications

References 9 publications

Chronic Pain Severity in Opioid-Dependent Patients

Chronic Pain Severity in Opioid-Dependent Patients

The effects of a single exposure to uncontrollable stress on the subsequent conditioned place preference responses to oxycodone, cocaine, and ethanol in rats

Nonmedical use and abuse of scheduled medications prescribed for pain, pain-related symptoms, and psychiatric disorders: Patterns, user characteristics, and management options

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