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J Manipulative Physiol Ther. 2018 Mar - Apr;41(3):175-180. doi: 10.1016/j.jmpt.2017.12.003. Epub 2018 Feb 15.

Association Among Opioid Use, Treatment Preferences, and Perceptions of Physician Treatment Recommendations in Patients With Neck and Back Pain.

Author information

1
Palmer College of Chiropractic, Davenport, Iowa; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire. Electronic address: wbw@dartmouth.edu.
2
Palmer College of Chiropractic, Davenport, Iowa.

Abstract

OBJECTIVE:

The purpose of this study was to explore the relationship between self-reported use of opioids by patients with neck and back pain and their demographics, pain characteristics, treatment preferences, and recollections of their physicians' opinions regarding treatment options.

METHODS:

We analyzed 2017 Gallup Poll survey data from 1680 US adults who had substantial spine pain in the past year and used logistic regression to explore the aforementioned relationships.

RESULTS:

Our multiple regression analysis indicated that adults with neck or back pain severe enough to have sought health care within the last year were more likely to have used opioids in the last year if they (in descending order of marginal impact) had pain that had lasted 1 year or less (adjusted odds ratio [OR] = 34.35, 90% confidence interval [CI] 17.56-74.32); concurrently used benzodiazepines (OR = 6.02, 90% CI 2.95-12.33); had Medicaid as an insurance source (OR = 3.29, 90% CI 1.40-7.48); indicated that they preferred to use pain medications prescribed by a doctor to treat physical pain (OR = 3.24, 90% CI 1.88-5.60); or were not college educated (OR = 1.83, 90% CI 1.05-3.25). Compared with patients aged 65 years and older, those aged 18 to 34 years were less likely to have used opioids in the past year (OR = 0.09, 90% CI 0.01-0.40, 0.50 for 95% CI). Respondents' perceptions of medical doctors' positive or negative opinions regarding a variety of neck and back pain treatment options were not significantly associated with opioid use.

CONCLUSIONS:

Patients with neck and back pain who use opioids differ from those who do not use opioids in that they are more likely to have pain that is of shorter duration, to use benzodiazepines, to have Medicaid as an insurance source, and to prefer to use pain medications. Those characteristics should be considered when developing opioid use prevention strategies.

KEYWORDS:

Analgesics, Opioids; Back Pain; Patient Preference; Spine

PMID:
29456094
DOI:
10.1016/j.jmpt.2017.12.003

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