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J Am Board Fam Med. 2011 Nov-Dec;24(6):717-27. doi: 10.3122/jabfm.2011.06.100232.

Opioids for back pain patients: primary care prescribing patterns and use of services.

Author information

  • 1Department of Family Medicine, Oregon Health and Science University, Portland, OR 972329, USA. deyor@ohsu.edu

Abstract

BACKGROUND:

Opioid prescribing for noncancer pain has increased dramatically. We examined whether the prevalence of unhealthy lifestyles, psychologic distress, health care utilization, and co-prescribing of sedative-hypnotics increased with increasing duration of prescription opioid use.

METHODS:

We analyzed electronic data for 6 months before and after an index visit for back pain in a managed care plan. Use of opioids was characterized as "none," "acute" (≤90 days), "episodic," or "long term." Associations with lifestyle factors, psychologic distress, and utilization were adjusted for demographics and comorbidity.

RESULTS:

There were 26,014 eligible patients. Of these, 61% received a course of opioids, and 19% were long-term users. Psychologic distress, unhealthy lifestyles, and utilization were associated incrementally with duration of opioid prescription, not just with chronic use. Among long-term opioid users, 59% received only short-acting drugs; 39% received both long- and short-acting drugs; and 44% received a sedative-hypnotic. Of those with any opioid use, 36% had an emergency visit.

CONCLUSIONS:

Prescription of opioids was common among patients with back pain. The prevalence of psychologic distress, unhealthy lifestyles, and health care utilization increased incrementally with duration of use. Coprescribing sedative-hypnotics was common. These data may help in predicting long-term opioid use and improving the safety of opioid prescribing.

PMID:
22086815
[PubMed - indexed for MEDLINE]
PMCID:
PMC3855548
Free PMC Article

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