Predictors of Long-Term Opioid Use

Thielke, S. M., Shortreed, S. M., Saunders, K., Turner, J.A., LaResche, L., & Von Korff, M. (2017). A prospective study of predictors of long-term opioid use among patients with chronic noncancer pain.  The Clinical Journal of Pain, 33 (3), 198-204.

An increase in opioid use disorders and fatal overdoses has resulted in a public health crisis in many regions of the United States and Canada. At the same time, as Thielke and colleagues (2017) pointed out, there is little evidence to support the effectiveness of the long-term use of opioids to treat chronic pain. Thus, these authors sought to identify the factors that result in long-term opioid use. They surveyed 762 adult members of a Washington State healthcare group who had been prescribed opioid therapy for chronic pain unrelated to cancer. The researchers assessed the participants’ levels of chronic pain, previous problematic substance use, depression, and expectations about the duration of their opioid use. After one year, electronic pharmacy data indicated that 46% of the participants were still using opioids. Although each of the four measures were associated with long-term opioid use, the strongest predictor was the participants’ expectations. Interestingly, the chronic pain scores was the weakest predictor of long-term opioid use. The authors suggested that educational interventions that shape patient expectations may be an effective strategy for reducing long-term opioid use and abuse.

Making Connections

Substance use

Media Supplement

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