Highlights
- •35% of patients continue to use opioids 4 months after traumatic injury.
- •Understanding opioid use after traumatic injury requires an evaluation of pain.
- •Pain intensity and coping predict persistent opioid use after traumatic injury.
Abstract
The aim of the present study was to examine the incidence and predictors of persistent
prescription opioid use 4 months after traumatic injury. Adults who sustained a traumatic
musculoskeletal injury were recruited to participate in this observational prospective,
longitudinal study within 14 days of injury (T1) and followed for 4 months (T2). Measures
included questionnaires on pain, opioid consumption, pain disability, anxiety, depression,
and posttraumatic stress symptoms as well as a chart review for injury related information.
The sample consisted of 122 patients (66.4% male; mean age = 44.8 years, SD = 17.1),
of whom 94.3% (n = 115) were using prescription opioids. At T2, 35.3% (n = 43) patients
were using prescription opioids. After controlling for age, sex, injury severity,
T1 pain severity, and T2 symptoms of depression, 2 factors emerged as significantly
related to T2 prescription opioid use; namely, T2 pain severity (odds ratio = 1.248,
95% confidence interval, 1.071–1.742) and T2 pain self-efficacy (odds ratio = .943,
95% confidence interval, .903–.984). These results suggest that opioid use after traumatic
musculoskeletal injury is related to pain severity and how well patients cope specifically
with their pain, over and above other psychological factors, such as depression and
anxiety.
Perspective
This article identifies predictive factors for prescription opioid use after traumatic
musculoskeletal injury, namely severe pain and a poor sense of control over the pain.
These results highlight the importance of using prospective longitudinal study designs
to understand why patients continue to use prescription opioids after major tissue-damaging
events.
Key words
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Article info
Publication history
Published online: March 24, 2017
Accepted:
March 13,
2017
Received in revised form:
January 13,
2017
Received:
August 8,
2016
Footnotes
Current address for Colin J.L. McCartney, Department of Anesthesiology and Pain Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada.
Brittany N. Rosenbloom was supported through an Ontario Graduate Scholarship. Joel Katz is supported by a Canada Research Chair in Health Psychology at York University.
The authors have no conflicts of interest to declare.
Identification
Copyright
© 2017 by the American Pain Society
