Journal of Rehabilitation Research & Development (JRRD)

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Volume 53 Number 1, 2016
   Pages 25 — 36

Abstract — Correlates of prescription opioid therapy in Veterans with chronic pain and history of substance use disorder

Travis I. Lovejoy, PhD, MPH;1* Steven K. Dobscha, MD;1 Dennis C. Turk, PhD;2 Melissa B. Weimer, DO, MCR;3 Benjamin J. Morasco, PhD1

1Mental Health and Clinical Neurosciences Division and Center to Improve Veteran Involvement in Care, Department of Veterans Affairs Portland Health Care System, Portland, OR; and Department of Psychiatry, Oregon Health and Science University, Portland, OR; 2Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA; 3Department of Medicine, Oregon Health and Science University, Portland, OR

Abstract — Patients with a history of substance use disorder (SUD) are more likely to be prescribed opioid medications for chronic pain than patients without an SUD history; however, little is known about prescription opioid therapy in populations composed exclusively of patients with SUD. This study examined correlates of prescription opioid therapy in 214 Veterans with chronic noncancer pain and an SUD history. Participants completed psychosocial questionnaires and participated in a structured mental health diagnostic interview, and medical diagnoses and opioid pharmacy data were abstracted from their Department of Veterans Affairs electronic medical records. Participants were categorized into three groups based on opioid prescriptions in the past 90 d: no opioid therapy (n = 134), short-term (<90 d) opioid therapy (n = 31), or long-term (>/= 90 d) opioid therapy (n = 49). Relative to participants prescribed no or short-term opioid therapy, participants who were prescribed long-term opioid therapy had a greater number of pain diagnoses; reported higher levels of pain severity, interference, and ??catastrophizing; and endorsed lower chronic pain self-efficacy. In a multivariate model, number of pain diagnoses and pain interference were associated with a greater likelihood of being prescribed long-term opioid therapy after controlling for demographic and clinical characteristics. Findings highlight the poor pain-related functioning in patients with SUD histories who are prescribed long-term opioid therapy.

Key words: chronic noncancer pain, chronic pain, long-term opioid therapy, opioids, pain, pain interference, prescription opioid therapy, short-term opioid therapy, substance use disorder, Veterans.


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This article and any supplementary material should be cited as follows:
Lovejoy TI, Dobscha SK, Turk DC, Weimer MB, Morasco BJ. Correlates of prescription opioid therapy in Veterans with chronic pain and history of substance use disorder. J Rehabil Res Dev. 2016;53(1):25–36.
http://dx.doi.org/10.1682/JRRD.2014.10.0230
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