Correlates of indicators of potential extra-medical opioid use in people prescribed opioids for chronic non-cancer pain

Authors

Thomas Santo
Briony K. Larance, University of WollongongFollow
Raimondo Bruno
Natasa Gisev
Suzanne Nielsen
Louisa Degenhardt
Gabrielle Campbell

RIS ID

140770

Publication Details

Santo, T., Larance, B., Bruno, R., Gisev, N., Nielsen, S., Degenhardt, L. & Campbell, G. (2019). Correlates of indicators of potential extra-medical opioid use in people prescribed opioids for chronic non-cancer pain. Drug and Alcohol Review,

Abstract

2019 Australasian Professional Society on Alcohol and other Drugs Introduction and Aims: The opioid-related behaviours in treatment (ORBIT) scale are a measure of recent indicators of potential extra-medical opioid use. Indicators of potential extra-medical opioid use are divergent practices among people prescribed opioids that may place them at risk of harm. This study aimed to examine the correlates of indicators of potential extra-medical opioid use in people prescribed opioids for chronic non-cancer pain (CNCP). Design and Methods: The Pain and Opioids IN Treatment (POINT) study is a prospective cohort study of people prescribed opioids for CNCP in Australia. People prescribed opioids solely for opioid dependence were excluded. This cross-sectional study utilised logistic regression to determine the characteristics associated with reporting any indicators of potential extra-medical opioid use. Results: Of the 1505 participants, 38% reported at least one indicator of potential extra-medical opioid use, most commonly asking for an increase in prescribed opioid dose (21%) and early prescription renewal (12%). Indicators of potential extra-medical opioid use were associated with younger age (adjusted odds ratio [AOR] = 0.98; 95% confidence interval [CI] = 0.92, 0.99), male sex (AOR = 1.53; 95% CI = 1.15, 2.04), lifetime pharmaceutical opioid use disorder (AOR = 1.87; 95% CI = 1.31, 2.66) and lifetime illicit drug use disorder (AOR = 1.72; 95% CI = 1.18, 2.52). Discussion and Conclusions: Over one-third of the POINT cohort reported one or more indicators of potential extra-medical opioid use. Lifetime substance use disorders were associated these divergent practices, highlighting the importance of clinical monitoring and patient education for this patient group. Longitudinal studies are needed to investigate whether indicators of potential extra-medical opioid use predict opioid use disorders in this population.