Pharmaceutical opioid use and dependence among people living with chronic pain: associations observed within the pain and opioids in treatment (POINT) cohort

Campbell, Gabrielle, Nielsen, Suzanne, Larance, Briony, Bruno, Raimondo, Mattick, Richard, Hall, Wayne, Lintzeris, Nicholas, Cohen, Milton, Smith, Kimberley and Degenhardt, Louisa (2015) Pharmaceutical opioid use and dependence among people living with chronic pain: associations observed within the pain and opioids in treatment (POINT) cohort. Pain Medicine (United States), 16 9: 1745-1758. doi:10.1111/pme.12773


Author Campbell, Gabrielle
Nielsen, Suzanne
Larance, Briony
Bruno, Raimondo
Mattick, Richard
Hall, Wayne
Lintzeris, Nicholas
Cohen, Milton
Smith, Kimberley
Degenhardt, Louisa
Title Pharmaceutical opioid use and dependence among people living with chronic pain: associations observed within the pain and opioids in treatment (POINT) cohort
Journal name Pain Medicine (United States)   Check publisher's open access policy
ISSN 1526-4637
1526-2375
Publication date 2015-05-22
Sub-type Article (original research)
DOI 10.1111/pme.12773
Open Access Status Not Open Access
Volume 16
Issue 9
Start page 1745
End page 1758
Total pages 14
Place of publication Hoboken, NJ, United States
Publisher Wiley-Blackwell Publishing
Language eng
Formatted abstract
Objective:  There is increasing concern about the appropriateness of prescribing pharmaceutical opioids for chronic non-cancer pain (CNCP), given the risks of problematic use and dependence. This article examines pharmaceutical opioid dose and dependence and examines the correlates of each.

Design:  Baseline data were obtained from a national sample of 1,424 people across Australia (median 58 years, 55% female and experiencing pain for a median of 10 years), who had been prescribed opioids for CNCP. Current opioid consumption was estimated in oral morphine equivalent (OME; mg per day), and ICD-10 pharmaceutical opioid dependence was assessed using the Composite International Diagnostic Interview.

Results:  Current opioid consumption varied widely: 8.8% were taking <20 mg OME per day, 52.1% were taking 21–90 mg OME, 24.3% were taking 91–199 mg OME, and 14.8% were taking >= 200 mg OME. Greater daily OME consumption was associated with higher odds of multiple physical and mental health issues, aberrant opioid use, problems associated with opioid medication and opioid dependence. A significant minority, 8.5%, met criteria for lifetime ICD-10 pharmaceutical opioid dependence and 4.7% met criteria for past year ICD-10 pharmaceutical opioid dependence. Multivariate analysis found past-year dependence was independently associated with being younger, exhibiting more aberrant behaviors and having a history of benzodiazepine dependence.

Conclusions:  In this population of people taking opioids for CNCP, consumption of higher doses was associated with increased risk of problematic behaviors, and was more likely among people with a complex profile of physical and mental health problems.
Keyword Chronic Pain
Dependence
Opioids
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Early view of article. Published online 22 May, 2015.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
Centre for Youth Substance Abuse Research Publications
 
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