Prescription medication misuse and substance use disorder in VA primary care patients with chronic pain

Benjamin J. Morasco; Steven K. Dobscha

doi:10.1016/j.genhosppsych.2007.12.004

Prescription medication misuse and substance use disorder in VA primary care patients with chronic pain

Benjamin J. Morasco
, Steven K. Dobscha

Psychiatry

Research output: Contribution to journal › Article › peer-review

110 Scopus citations

Abstract

Objective: The goal of this paper was to examine the relationship between history of substance use disorder (SUD) and self-reported prescription medication misuse in 127 primary care patients who receive opioid medications for treatment of chronic pain. Method: Participants completed measures of pain location, pain intensity, disability due to pain, and misuse of prescription medications. Other measures included demographic characteristics, psychiatric symptomatology and quality of life. Results: Seventy-eight percent of participants reported at least one indicator of medication misuse in the prior year. After adjusting for age and clinical factors (pain severity, depression severity, current alcohol or substance use disorder), participants with SUD history were significantly more likely than participants without SUD history to report borrowing pain medications from others (OR=6.62, 95% CI=1.4-30.7) and requesting an early refill of pain medication (OR=3.86, 95% CI=1.5-9.6). Conclusions: Misuse of prescription medications is a concern among primary care patients with chronic pain. Participants with a lifetime history of SUD are more likely to endorse some aberrant medication-related behaviors. Patients with SUD histories should be carefully evaluated for medication misuse potential and may require more intense assessment and follow-up.

Original language	English (US)
Pages (from-to)	93-99
Number of pages	7
Journal	General Hospital Psychiatry
Volume	30
Issue number	2
DOIs	https://doi.org/10.1016/j.genhosppsych.2007.12.004
State	Published - Mar 2008

Funding

The research reported here was supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service Projects PMI 03-195 and RCD04129. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. We appreciate the assistance of Alex Linke for obtaining electronic medical record data and Dr. Dennis Turk for reviewing a draft of this manuscript.

Funders	Funder number
U.S. Department of Veterans Affairs
Health Services Research and Development	PMI 03-195, RCD04129

Keywords

Chronic pain
Medication misuse
Opiates
Primary care
Substance use disorder

ASJC Scopus subject areas

Psychiatry and Mental health

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10.1016/j.genhosppsych.2007.12.004

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title = "Prescription medication misuse and substance use disorder in VA primary care patients with chronic pain",

abstract = "Objective: The goal of this paper was to examine the relationship between history of substance use disorder (SUD) and self-reported prescription medication misuse in 127 primary care patients who receive opioid medications for treatment of chronic pain. Method: Participants completed measures of pain location, pain intensity, disability due to pain, and misuse of prescription medications. Other measures included demographic characteristics, psychiatric symptomatology and quality of life. Results: Seventy-eight percent of participants reported at least one indicator of medication misuse in the prior year. After adjusting for age and clinical factors (pain severity, depression severity, current alcohol or substance use disorder), participants with SUD history were significantly more likely than participants without SUD history to report borrowing pain medications from others (OR=6.62, 95\% CI=1.4-30.7) and requesting an early refill of pain medication (OR=3.86, 95\% CI=1.5-9.6). Conclusions: Misuse of prescription medications is a concern among primary care patients with chronic pain. Participants with a lifetime history of SUD are more likely to endorse some aberrant medication-related behaviors. Patients with SUD histories should be carefully evaluated for medication misuse potential and may require more intense assessment and follow-up.",

keywords = "Chronic pain, Medication misuse, Opiates, Primary care, Substance use disorder",

author = "Morasco, \{Benjamin J.\} and Dobscha, \{Steven K.\}",

note = "Funding Information: The research reported here was supported by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service Projects PMI 03-195 and RCD04129. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. We appreciate the assistance of Alex Linke for obtaining electronic medical record data and Dr. Dennis Turk for reviewing a draft of this manuscript.",

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AU - Dobscha, Steven K.

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N2 - Objective: The goal of this paper was to examine the relationship between history of substance use disorder (SUD) and self-reported prescription medication misuse in 127 primary care patients who receive opioid medications for treatment of chronic pain. Method: Participants completed measures of pain location, pain intensity, disability due to pain, and misuse of prescription medications. Other measures included demographic characteristics, psychiatric symptomatology and quality of life. Results: Seventy-eight percent of participants reported at least one indicator of medication misuse in the prior year. After adjusting for age and clinical factors (pain severity, depression severity, current alcohol or substance use disorder), participants with SUD history were significantly more likely than participants without SUD history to report borrowing pain medications from others (OR=6.62, 95% CI=1.4-30.7) and requesting an early refill of pain medication (OR=3.86, 95% CI=1.5-9.6). Conclusions: Misuse of prescription medications is a concern among primary care patients with chronic pain. Participants with a lifetime history of SUD are more likely to endorse some aberrant medication-related behaviors. Patients with SUD histories should be carefully evaluated for medication misuse potential and may require more intense assessment and follow-up.

AB - Objective: The goal of this paper was to examine the relationship between history of substance use disorder (SUD) and self-reported prescription medication misuse in 127 primary care patients who receive opioid medications for treatment of chronic pain. Method: Participants completed measures of pain location, pain intensity, disability due to pain, and misuse of prescription medications. Other measures included demographic characteristics, psychiatric symptomatology and quality of life. Results: Seventy-eight percent of participants reported at least one indicator of medication misuse in the prior year. After adjusting for age and clinical factors (pain severity, depression severity, current alcohol or substance use disorder), participants with SUD history were significantly more likely than participants without SUD history to report borrowing pain medications from others (OR=6.62, 95% CI=1.4-30.7) and requesting an early refill of pain medication (OR=3.86, 95% CI=1.5-9.6). Conclusions: Misuse of prescription medications is a concern among primary care patients with chronic pain. Participants with a lifetime history of SUD are more likely to endorse some aberrant medication-related behaviors. Patients with SUD histories should be carefully evaluated for medication misuse potential and may require more intense assessment and follow-up.

KW - Chronic pain

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KW - Opiates

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KW - Substance use disorder

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Prescription medication misuse and substance use disorder in VA primary care patients with chronic pain

Abstract

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Keywords

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