scholarly journals The SISAP: A New Screening Instrument for Identifying Potential Opioid Abusers in the Management of Chronic Nonmalignant Pain Within General Medical Practice

1996 ◽  
Vol 1 (3) ◽  
pp. 155-162 ◽  
Author(s):  
Robert B Coambs ◽  
Josée L Jarry ◽  
Anusha C Santhiapillai ◽  
Rixi V Abrahamsohn ◽  
Cristina M Atance
Keyword(s):  
Substance Abuse ◽  
Chronic Pain ◽  
Drug Use ◽  
Illicit Drug ◽  
Substance Abusers ◽  
Opioid Analgesics ◽  
Illicit Drug Use ◽  
Screening Instrument ◽  
Prior History ◽  
History Of

BACKGROUND:Many physicians are overly cautious about prescribing opioids for chronic pain because of fears of iatrogenic addiction. However, in patients with chronic pain, addiction to opioid analgesics is exceedingly rare when there is no prior history of alcohol or drug abuse.OBJECTIVE:To validate an instrument that separates possible opioid abusers from those who are at low risk.DESIGN/METHODS:The Screening Instrument for Substance Abuse Potential (SISAP) was designed to identify individuals with a possible substance abuse history quickly and accurately. It is based on the National Alcohol and Drug Use Survey (n=9915). Using the first half of the sample (n=4967), two previously validated alcohol use items were combined with three illicit drug use items. These five questions identified those with a history of alcohol and/or illicit drug use.RESULTS:Using the second half of the sample (n=4948), the validation procedure showed that the five combined items correctly classified 91% of substance abusers and had a low rate of false negatives.DISCUSSION:The SISAP is brief and resistant to misrepresentation or falsification. The SISAP is expected to improve pain management by facilitating focus on the appropriate use of opioid analgesics and therapeutic outcomes in the majority of patients who are not at risk of opioid abuse, while carefully monitoring those who may be at greater risk.

scholarly journals A qualitative exploration of chronic pain and opioid treatment among HIV patients with drug use disorders

2017 ◽  
Vol 13 (1) ◽  
pp. 5 ◽  
Author(s):  
Sarina R. Isenberg, MA ◽  
Allysha C. Maragh-Bass, MPH, PhD ◽  
Kathleen Ridgeway, MSPH ◽  
Mary Catherine Beach, MD, MPH ◽  
Amy R. Knowlton, MPH, ScD
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Drug Use ◽  
Illicit Drug ◽  
Pain Treatment ◽  
Opioid Analgesics ◽  
Illicit Drug Use ◽  
Prescription Opioids ◽  
Community Based Research ◽  
History Of

Objective: The study explored high-risk participants' experiences with pain management regarding clinical access to and use of prescription opioids.Design: Qualitative semistructured interviews and focus groups.Setting: Data were collected August 2014 to May 2015 at an urban community-based research facility in Baltimore City, MD.Participants: HIV participants with chronic pain and a history of illicit drug use.Methods: Qualitative coding and analysis used an iterative, inductive, and thematic approach and coders achieved inter-coder consistency.Results: The authors identified two major themes. First, participants had positive and negative interactions with healthcare providers regarding chronic pain treatment. Participants perceived that providers lacked empathy for their pain and/or were not adequately managing their pain. These interactions resulted in participants seeking new providers or mistrusting the medical system. Further, providers’ surveillance of participants’ pain treatment regimen contributed to distress surrounding pain management. The second theme centered on participants’ pain management experiences with prescribed opioid analgesics. Participants felt they were receiving dosages and classes of analgesics that did not sufficiently address their pain, and consequently modified their dosages or rationed prescription opioids. Other participants were reluctant to take analgesics due to their history of illicit drug use. Some participants relapsed to illicit drug use when they felt their prescription opioids did not adequately address their pain needs.Conclusions: Participant struggles with receiving and managing prescribed opioid analgesics suggest a need for: therapies beyond these medications; guidelines for providers specific to this population; and harm reduction trainings for providers.

scholarly journals Psychological factors as predictors of opioid abuse and illicit drug use in chronic pain patients

2007 ◽  
Vol 3 (2) ◽  
pp. 89 ◽  
Author(s):  
Laxmaiah Manchikanti, MD ◽  
James Giordano, PhD ◽  
Mark V. Boswell, MD, PhD ◽  
Bert Fellows, MA ◽  
Rajeev Manchukonda, BDS ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Chronic Pain ◽  
Drug Abuse ◽  
Drug Use ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Opioid Abuse ◽  
Somatization Disorder ◽  
Chronic Pain Patients ◽  
Pain Patients

Background: Psychopathology (depression, anxiety, somatization disorder) and substance abuse (opioid mis-use and illicit drug use) are common in patients with chronic pain and present problems for public health and clinical management. Despite a body of literature describing various methods for identifying psychopathology, opioid misuse, and illicit drug use in chronic pain patients, the relationship between psychopathologies, substance abuse, and chronic pain has not been well characterized.Methods: This report describes a total of500 consecutive pain patients prescribed and receiving stable doses of opioids. The patients were evaluated for psychopathology, opioid abuse, and illicit drug use during the course of regular pain management treatment. The relationships between psychopathology and drug abuse and/or illicit drug use in chronic pain patients were examined, and psychological evaluation for depression, anxiety, and somatization disorder was performed.Results: Depression, anxiety, and somatization disorder were documented in 59, 64, and 30percent of chronic pain patients, respectively. Drug abuse was significantly higher in patients with depression as compared to patients without depression (12percent with depression versus 5percent without). Current illicit drug use was higher in women with depression (22 percent) than women without depression (14percent) and in men with or without depression (12percent). Current illicit drug use was also higher in men with somatization disorder (22 percent) than men without (9 percent).Conclusion: This study demonstrated that the presence of psychological features of depression and somatization disorder may be markers of substance abuse diathesis in chronic pain patients.

Outcomes of coronary artery bypass grafting in patients with a history of illicit drug use

2003 ◽  
Vol 92 (5) ◽  
pp. 593-595 ◽  
Author(s):  
Praphul Misra ◽  
Gloria C. Caldito ◽  
Aman K. Kakkar ◽  
Mary C. Mancini ◽  
Pratap C. Reddy
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Drug Use ◽  
Coronary Artery Bypass ◽  
Illicit Drug ◽  
Artery Bypass ◽  
Illicit Drug Use ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
History Of

scholarly journals Pattern of Psychoactive Substances Use among Long-Distance Truck Drivers in Nigeria

2021 ◽  
pp. 18-25
Author(s):  
Mobolaji Usman Dada ◽  
Adekunle Olatayo Adeoti ◽  
Tobiloba Elebiyo ◽  
Banji Ferdinand ` Kumolalo ◽  
Adedotun Samuel Ajiboye
Keyword(s):  
Drug Use ◽  
Prescription Drugs ◽  
Illicit Drug ◽  
Opioid Analgesics ◽  
Illicit Drug Use ◽  
Truck Drivers ◽  
High Rate ◽  
Psychoactive Drugs ◽  
Long Distance ◽  
Cross Sectional

Aims: This study was designed to examine the pattern of psychoactive drugs use among long-distance truck drivers in Ado-Ekiti, Ekiti state, Nigeria. Study Design: This was a descriptive cross sectional study. Place and Duration: The study was conducted at the converging motor park for truck drivers in Ado-Ekiti, south-west Nigeria between September and December 2019. Methods: The pattern of psychoactive drugs use among 306 adult male truck drivers was determined using a semi-structured questionnaire in addition to a sociodemographic questionnaire. Data was analyzed and logistic regression was used to identify significant predictors of illicit drug use. Results: Among the 306 study participants, 43.7% consumed alcohol.  The major non-prescription drugs used by the truck drivers were cough syrups (67.0%); analgesics (49.3%); cannabis (39.9%); amphetamine/methamphetamine (33.0%) and tranquilizers (32.0%). Opioid analgesics like tramadol (35.1%) and morphine (22.3%) were the commonly used analgesics. The predictor of psychoactive drugs use among the long-distance truck drivers is the co-use of alcohol and tobacco (AOR (1.71) 95% CI (1.24–2.36%). Conclusion: There is a high rate of psychoactive drugs use among truck drivers. There is an urgent need to educate the truck drivers on the adverse implications of illicit drug use and the need to abstain for better health promotion.

Association between tobacco use and symptom expression, alcoholism, and illicit drug use in patients with advanced cancer.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 154-154
Author(s):  
YuJung Kim ◽  
Rony Dev ◽  
Akhila Sunkepally Reddy ◽  
David Hui ◽  
Gary B. Chisholm ◽  
...  
Keyword(s):  
Drug Use ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Advanced Cancer Patients ◽  
Pain Expression ◽  
History Of ◽  
Former Smokers ◽  
Never Smokers

154 Background: Our aim was to determine the association between smoking status and symptom expression, opioid use, alcoholism, and illicit drug use in advanced cancer patients. Methods: We retrospectively reviewed 560 consecutive charts from the outpatient Supportive Care Center and identified 300 advanced cancer patients who completed a comprehensive smoking questionnaire. Data on the Edmonton Symptom Assessment Scale (ESAS), morphine equivalent daily dose (MEDD), CAGE (Cut Down, Annoyed, Guilty, Eye Opener) questionnaire for alcoholism screening, and history of illicit drug use were collected. Results: Among 300 advanced cancer patients, 119 (40%) were never-smokers, 148 (49%) were former smokers, and 33 (11%) were current smokers. Compared with never-smokers, current smokers were more likely to be men (58% vs. 29%, P=0.004), report a higher pain expression (median 7.0 vs. 5.0 by the ESAS, P=0.007), be CAGE positive (≥2 yes response) (42% vs. 3%, P<0.001), and have a history of illicit drug use (33% vs. 3%, P<0.001). Compared with never-smokers, former smokers were more likely to be men (60% vs. 29%, P<0.001), have head and neck cancer or lung cancer (30% vs. 13%, P=0.001), be CAGE positive (21% vs. 3%, P<0.001), and have a history of illicit drug use (16% vs. 3%, P<0.001). Current smokers reported a higher pain expression than former smokers (median 7.0 vs. 6.0 by the ESAS, P=0.01), had higher CAGE positivity (42% vs. 21%, P=0.01) and more frequent illicit drug use (33% vs. 16%, P=0.03). The MEDD and the timing of palliative care referral were not significantly different between current or former smokers compared with never-smokers. However, a higher proportion of current smokers were receiving opioids with MEDD ≥30mg at the time of palliative care consultation compared with never-smokers (70% vs. 52%, P=0.08). Conclusions: Our study suggests that current tobacco use is associated with a higher pain expression. In addition, any history of tobacco use is associated with a history of illicit drug use and alcoholism. Advanced cancer patients who smoked cigarettes may be at an increased risk for chemical coping or stronger opioid utilization and further studies are needed.

scholarly journals Auditory skill analysis of a group of subjects with history of illicit drug use

2009 ◽  
Vol 75 (5) ◽  
pp. 685-693
Author(s):  
Daniela de Lucas Rosseto ◽  
Silvana Cristina Ribeiro ◽  
Mônica Pires de Castro Mendonça ◽  
José Antônio A. de Oliveira ◽  
Ana Cláudia Mirândola Barbosa Reis ◽  
...  
Keyword(s):  
Drug Use ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
History Of ◽  
Skill Analysis

Testing a General Theory of Drug Abuse and other Deviant Adaptations

1985 ◽  
Vol 15 (4) ◽  
pp. 477-492 ◽  
Author(s):  
Howard B. Kaplan
Keyword(s):  
Drug Use ◽  
General Theory ◽  
Illicit Drug ◽  
Deviant Behavior ◽  
Multivariate Analyses ◽  
Illicit Drug Use ◽  
The Self ◽  
Social Evaluation ◽  
Level Of Involvement ◽  
History Of

I present an outline of the current state of an evolving general theory of deviant behavior, particularly as it applies to the explanation of the onset and continuity or change in level of involvement in illicit drug use. Self-derogation remains a central organizing concept in the theory. The need for self-approval disposes a person to illicit drug use, depending upon the social evaluation of this pattern in the person's membership/reference groups and the history of net self-enhancing/self-devaluing experiences in these groups. The initiation of illicit drug use is a function of circumstances influencing the opportunities for, and the self-evaluative relevance of anticipated consequences of, the illicit drug use. The continuity of the illicit drug use is a function of the self-evaluative relevance of the perceived consequences of initial drug use, and of changes in the circumstances that provide opportunities for and redefine the self-evaluative relevance of normative standards. The results of recent multivariate analyses are described. These results point to the usefulness of the theory both as a guide for research and as a framework for integrating the results of multivariate analyses estimating the onset and continuity or changes in level of involvement in illicit drug use.

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