Abstract
This study examined characteristics associated with prescription drug use disorder
(PDUD) in primary-care patients with chronic pain from a cross-sectional survey conducted
at an urban academically affiliated safety-net hospital. Participants were 18 to 60
years old, had pain for >3 months, took prescription or nonprescription analgesics, and spoke English. Measurements
included the Composite International Diagnostic Interview (PDUD, other substance use
disorders (SUD), Posttraumatic Stress Disorder [PTSD]); Graded Chronic Pain Scale,
smoking status; family history of SUD; and time spent in jail. Of 597 patients (41%
male, 61% black, mean age 46 years), 110 (18.4%) had PDUD of whom 99 (90%) had another
SUD. In adjusted analyses, those with PDUD were more likely than those without any
current or past SUD to report jail time (OR 5.1, 95% CI 2.8–9.3), family history of
SUD (OR 3.4, 1.9-6), greater pain-related limitations (OR 3.8, 1.2-11.7), cigarette
smoking (OR 3.6, 2–6.2), or to be white (OR 3.2, 1.7–6), male (OR 1.9, 1.1–3.5) or
have PTSD (OR 1.9, 1.1–3.4). PDUD appears increased among those with easily identifiable
characteristics. The challenge is to determine who, among those with risk factors,
can avoid, with proper management, developing the increasingly common diagnosis of
PDUD.
Perspective
This article examines risk factors for prescription drug use disorder (PDUD) among
a sample of primary-care patients with chronic pain at an urban, academic, safety-net
hospital. The findings may help clinicians identify those most at risk for developing
PDUD when developing appropriate treatment plans.
Key words
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Article info
Publication history
Published online: March 25, 2010
Accepted:
October 27,
2009
Received in revised form:
August 11,
2009
Received:
March 17,
2009
Footnotes
Supported by K23 DA016665 and K24 DA022288 from the National Institute of Drug Abuse and K24 AA015674 from the National Institute on Alcohol Abuse and Alcoholism.
Identification
Copyright
© 2010 American Pain Society. Published by Elsevier Inc. All rights reserved.
