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Addiction. 2010 Oct;105(10):1776-82. doi: 10.1111/j.1360-0443.2010.03052.x. Epub 2010 Aug 16.

Risk factors for drug dependence among out-patients on opioid therapy in a large US health-care system.

Author information

  • 1Center for Health Research, Geisinger Health System, Danville, PA 17822-4400, USA. jaboscarino@geisinger.edu

Abstract

AIMS:

Our study sought to assess the prevalence of and risk factors for opioid drug dependence among out-patients on long-term opioid therapy in a large health-care system.

METHODS:

Using electronic health records, we identified out-patients receiving 4+ physician orders for opioid therapy in the past 12 months for non-cancer pain within a large US health-care system. We completed diagnostic interviews with 705 of these patients to identify opioid use disorders and assess risk factors.

RESULTS:

Preliminary analyses suggested that current opioid dependence might be as high as 26% [95% confidence interval (CI) = 22.0-29.9] among the patients studied. Logistic regressions indicated that current dependence was associated with variables often in the medical record, including age <65 [odds ratio (OR) = 2.33, P = 0.001], opioid abuse history (OR = 3.81, P < 0.001), high dependence severity (OR = 1.85, P = 0.001), major depression (OR = 1.29, P = 0.022) and psychotropic medication use (OR = 1.73, P = 0.006). Four variables combined (age, depression, psychotropic medications and pain impairment) predicted increased risk for current dependence, compared to those without these factors (OR = 8.01, P < 0.001). Knowing that the patient also had a history of severe dependence and opioid abuse increased this risk substantially (OR = 56.36, P < 0.001).

CONCLUSION:

Opioid misuse and dependence among prescription opioid patients in the United States may be higher than expected. A small number of factors, many documented in the medical record, predicted opioid dependence among the out-patients studied. These preliminary findings should be useful in future research efforts.

© 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

PMID:
20712819
[PubMed - indexed for MEDLINE]
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