Defining problematic pharmaceutical opioid use among people prescribed opioids for chronic noncancer pain: do different measures identify the same patients?

Campbell, Gabrielle, Bruno, Raimondo, Lintzeris, Nicholas, Cohen, Milton, Nielsen, Suzanne, Hall, Wayne, Larance, Briony, Mattick, Richard P., Blyth, Fiona, Farrell, Michael and Degenhardt, Louisa (2016) Defining problematic pharmaceutical opioid use among people prescribed opioids for chronic noncancer pain: do different measures identify the same patients?. Pain, 157 7: 1489-1498. doi:10.1097/j.pain.0000000000000548


Author Campbell, Gabrielle
Bruno, Raimondo
Lintzeris, Nicholas
Cohen, Milton
Nielsen, Suzanne
Hall, Wayne
Larance, Briony
Mattick, Richard P.
Blyth, Fiona
Farrell, Michael
Degenhardt, Louisa
Title Defining problematic pharmaceutical opioid use among people prescribed opioids for chronic noncancer pain: do different measures identify the same patients?
Journal name Pain   Check publisher's open access policy
ISSN 1872-6623
0304-3959
Publication date 2016-07-01
Year available 2016
Sub-type Article (original research)
DOI 10.1097/j.pain.0000000000000548
Open Access Status Not yet assessed
Volume 157
Issue 7
Start page 1489
End page 1498
Total pages 10
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Collection year 2017
Language eng
Formatted abstract
The International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual (DSM) are routinely used in diagnosing illicit substance use disorders, but for people taking prescribed opioids they remain controversial. In pain medicine, the concept of "Addiction" is preferred with reduced emphasis on tolerance and withdrawal. This article examines the prevalence and characteristics of pharmaceutical opioid dependence/disorder according to ICD, DSM, and the pain medicine concept of "Addiction," among chronic noncancer pain (CNCP) patients prescribed opioids. In the current study, we used data from a national sample of 1134 people prescribed opioids for CNCP. Past 12-month "Addiction" (based on Pain Medicine definition), DSM, and ICD dependence definitions were assessed using the Composite International Diagnostic Interview. Twenty-four percent of the cohort met the criteria for "Addiction," 18% for DSM-5 use disorder and 19% for ICD-11 dependence. There was "substantial" concordance between "Addiction" and both DSM-5 use disorder and ICD-11 dependence, although concordance was much greater with ICD-11 dependence (kappa 0.63 and 0.79, respectively). Participants meeting the criteria for "Addiction" only were older, less likely to engage in nonadherent behaviours, self-reported fewer problems or concerns with their medication, and had lower rates of psychological distress than those who also met the DSM-5 and ICD-11 criteria. The definition of "Addiction" captures a larger group of patients than other classification systems and includes people with fewer "risk" behaviours. Despite removal of tolerance and withdrawal for prescribed opioid use for DSM-5, we found that "Addiction" was more closely related to an ICD-11 diagnosis of pharmaceutical opioid dependence.
Keyword Addiction
Chronic noncancer pain
Dependence
Opioids
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
Centre for Youth Substance Abuse Research Publications
 
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