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Pain and Chemical Dependency News
Opioids can provide relief for chronic pain, but a few patients may develop
aberrant drug behaviors. Clinicians need to identify those at risk. These researchers
examined the evidence for published strategies that identify at-risk patients
in order to guide clinicians' decisions and practices for prescribing opioids
for chronic pain patients (CPP).
Studies selected screened for predictors of aberrant drug behaviors in CPP
who were prescribed long-term opioids. A total of 15 articles and studies were
identified. The investigators report that although attempts have been made to
use urine toxicology screening, structured interviews, observation, and self-report
questionnaires to identify at-risk patients, the designs of questionnaires and
interview protocols are weak, and the sample sizes in studies are often small
and not representative of the population.
The conclusion is that no one procedure or set of predictors is sufficient
to identify CPP at risk for opioid misuse or abuse. There is little evidence
regarding characteristics that predict aberrant behavior in patients before
they start long-term opioid therapy. Strong predictors identified are a personal
history of illicit drug and alcohol abuse. More research with CPP who have not
already started chronic opioid therapy is needed. Turk DC, Swanson KS, Gatchel
RJ. Adapted from Clin J Pain. 2008 Jul-Aug;24(6):497-508.
PMID: 18574359
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
Credit: PubMed, developed by the National Center for Biotechnology Information
(NCBI) at the
National Library of Medicine (NLM).
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