Patterns and Correlates of Prescription Opioid Use in OEF/OIF Veterans with Chronic Noncancer Pain

BACKGROUND: Chronic noncancer pain (CNCP) and prescription opioid use is a highly complex and growing health care issue in Canada. Many quantitative research studies have investigated the effectiveness of opioids for chronic pain; however, gaps remain in the literature regarding the personal experience of using opioids and their impact on those experiencing CNCP.OBJECTIVE: To explore the lived experience of adults using prescription opioids to manage CNCP, focusing on how opioid medication affected their daily lives.METHODS: In-depth qualitative interviews were conducted with nine adults between 40 and 68 years of age who were using prescription opioids daily for CNCP. Interviews were audiorecorded and transcribed, and subsequently analyzed using interpretive phenomenological analysis.RESULTS: Six major themes identified positive and negative aspects of opioid use associated with social, physical, emotional and psychological dimensions of pain management. These themes included the process of decision making, and physical and psychosocial consequences of using opioids including pharmacological side effects, feeling stigmatized, guilt, fears, ambivalence, self-protection and acceptance.CONCLUSION: Although there were many negative aspects to using opioids daily, the positive effects outweighed the negative for most participants and most of the negative aspects were socioculturally induced rather than caused by the drug itself. The present study highlighted the complexities involved in using prescription opioids daily for management of CNCP for individuals living with pain.

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Validation of the OWLS, a Screening Tool for Measuring Prescription Opioid Use Disorder in Primary Care

Pain Medicine ◽

10.1093/pm/pnaa275 ◽

2020 ◽

Vol 21 (11) ◽

pp. 2757-2764

Author(s):

Louisa Picco ◽

Melissa Middleton ◽

Raimondo Bruno ◽

Michala Kowalski ◽

Suzanne Nielsen

Keyword(s):

Primary Care ◽

Screening Tool ◽

Opioid Use Disorder ◽

Prescription Opioid ◽

Scoring Methods ◽

Opioid Use ◽

Operating Characteristics ◽

Scoring Method ◽

Chronic Noncancer Pain ◽

Prescription Opioid Use

Abstract Objective The OWLS is a screening tool for prescription opioid use disorder designed for use in primary care. This study aimed to confirm the optimal wording, scoring methods, and cutoff for the OWLS. Design and Setting Cross-sectional analysis of an online sample. Subjects Participants comprised those with chronic noncancer pain who regularly used prescription opioids. Methods Eligible participants self-completed an online version of the OWLS prescription opioid use disorder screening tool and the Composite International Diagnostic Interview Substance Abuse module. Receiver operating characteristics were calculated for three scoring methods for the OWLS, and these were compared with DSM-5 classification of any use disorder and moderate to severe opioid use disorder. Results Among the sample (N = 324), utilizing scoring method (i) (i.e., positive endorsement ≥ response option “a little bit”) and a cutoff of 3 increased the percentage of correctly classified participants, with concurrent increases in specificity and decreases in false discovery rate, and false positive rate. Conclusion OWLS utilizing scoring method (i) with a cutoff of 3 was shown to be the optimal version and scoring method of this tool. This represents a time-efficient, simple scoring method, allowing for quick and accurate screening for opioid use disorder to occur.

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Association of OPRM1 Polymorphisms With DSM-5–Defined Prescription Opioid Use Disorder Among Chronic Pain Patients on Opioid Therapy for Noncancer Pain

Journal of Patient-Centered Research and Reviews ◽

10.17294/2330-0698.1372 ◽

2016 ◽

Vol 3 (3) ◽

pp. 212-213

Author(s):

Joseph A Boscarino ◽

Stuart N Hoffman ◽

John J Han ◽

Xin Chu

Keyword(s):

Chronic Pain ◽

Opioid Therapy ◽

Opioid Use Disorder ◽

Prescription Opioid ◽

Opioid Use ◽

Dsm 5 ◽

Chronic Pain Patients ◽

Noncancer Pain ◽

Prescription Opioid Use ◽

Pain Patients

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Prescription Opioid Distribution After the Legalization of Recreational Marijuana in Colorado, 2007-2017

10.1101/702811 ◽

2019 ◽

Cited By ~ 1

Author(s):

Amalie K. Kropp ◽

Stephanie D. Nichols ◽

Daniel Y. Chung ◽

Kenneth L. McCall ◽

Brian J. Piper

Keyword(s):

United States ◽

Oral Morphine ◽

The United States ◽

Prescription Opioid ◽

Opioid Use ◽

Chronic Noncancer Pain ◽

Overdose Death ◽

Pain Medications ◽

Recreational Marijuana ◽

Noncancer Pain

AbstractImportanceOpioid related overdoses and overprescribing continue to be an ongoing issue within the United States. Further consideration of nonopioid alternatives as a substitute to treat chronic noncancer pain and in the treatment of opioid use disorders (OUD) is warranted.ObjectiveTo examine the association between the legalization of Colorado’s recreational marijuana and prescription opioid distribution trends. Two states that have not legalized recreational marijuana were selected for comparison.MethodsThe United States Drug Enforcement Administration’s Automation of Report and Consolidated Orders System (ARCOS) was used to examine nine pain medications: oxycodone, fentanyl, morphine, hydrocodone, hydromorphone, oxymorphone, tapentadol, codeine, meperidine and two OUD medications: methadone and buprenorphine from 2007-2017 in Colorado, Utah, and Maryland. The drug weights were extracted, examined, and graphed. Medications were converted to their oral morphine milligram equivalents (MME) using standard conversion factors.ResultsColorado reached a peak of pain MME weight in 2012 and had an −11.66% reduction from 2007 to 2017. During the same interval, Utah had a +9.64% increase in pain medication distribution and Maryland, a −6.02% reduction. As for medications used for OUD, Colorado, Utah, and Maryland had +19.42% increase, −31.45% reduction, and +66.56% increase, respectively. Analysis of the interval pre (2007-2009) versus post (2013-2017) marijuana legalization was completed. Statistically significant changes were observed for Colorado (P=0.033) and Maryland (P=0.007), but not Utah (P=0.659) for pain medications. Analysis of the OUD medications identified significant changes for Colorado (P=0.0003) and Maryland (P=0.0001), but not Utah (P=0.0935). Over the decade, Colorado’s opioid distribution was predominantly (72.49%) for pain with one-quarter (27.51%) for an OUD. Utah distributed 61.00% for pain and 39.00% for OUD. However, Maryland was one-third (37.89%) for pain but over-three-fifths (62.11%) for an OUD.ConclusionThere has been a significant decrease in the prescription opioid distribution after the legalization of marijuana in Colorado. This finding was particularly notable for opioids indicated predominantly for analgesia such as hydrocodone, morphine and fentanyl. Colorado had a larger decrease in opioid distribution after 2012 than Utah or Maryland. Therefore, marijuana could be considered as an alternative treatment for chronic pain and reducing use of opioids. Also, when combined with other novel research, it may also reduce the overdose death rate. Additional research with more comparison states is ongoing.

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