Risk factors for indicators of opioid-related harms amongst people living with chronic non-cancer pain: Findings from a 5-year prospective cohort study

Gabrielle Campbell; Firouzeh Noghrehchi; Suzanne Nielsen; Phillip Clare; Raimondo Bruno; Nicholas Lintzeris; Milton Cohen; Fiona Blyth; Wayne D Hall; Briony Larance; Phillip Hungerford; Timothy Dobbins; Michael Farrell; Louisa Degenhardt

doi:10.1016/j.eclinm.2020.100592

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Risk factors for indicators of opioid-related harms amongst people living with chronic non-cancer pain: Findings from a 5-year prospective cohort study

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Risk factors for indicators of opioid-related harms amongst people living with chronic non-cancer pain: Findings from a 5-year prospective cohort study

Gabrielle Campbell, Firouzeh Noghrehchi, Suzanne Nielsen, Phillip Clare, Raimondo Bruno, Nicholas Lintzeris, Milton Cohen, Fiona Blyth, Wayne D Hall, Briony Larance, …

EClinicalMedicine, Vol.28, 100592

2020

DOI: https://doi.org/10.1016/j.eclinm.2020.100592

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Abstract

chronic non-cancer pain

pharmaceutical opioid

dependence

extra medical use

cohort

Background: The literature suggests patient characteristics and higher opioid doses and long-term duration are associated with problematic opioid behaviours but no one study has examined the role of all these factors simultaneously in a long-term prospective cohort study. Methods: Five-year, community-based, prospective cohort of people prescribed opioids for chronic non-cancer pain (CNCP). Logistic mixed effect models with multiple imputation were used to address missing data. Oral morphine equivalent (OME) mg per day was categorised as: 0 mg OME/day, 1–49 mg OME/day (reference), 50–89 mg OME/day, 90–199 mg OME/day and 200mg+ OME/day. Patient risk factors included: age, gender, substance use, mental health history and pain-related factors. Main outcomes included: Prescribed Opioids Difficulties Scale (PODS), Opioid-Related Behaviours In Treatment (ORBIT) scale, and ICD-10 opioid dependence. Multiple confounders for problematic opioid behaviours were assessed. Findings: Of 1,514 participants 44.4% were male (95%CI 41.9–46.9) and their mean age was 58 years (IQR 48–67). Participants had a mean duration of pain of 10 years (IQR 4.5–20.0) and had been taking strong opioids for a median of four years (IQR 1.0–10.0). At baseline, median OME/day was 73 (IQR 35–148). At 5-years, 85% were still taking strong opioids. PODS moderate-high scores reduced from 59.9% (95%CI 58.8–61.0) at baseline to 51.5% (95%CI 50.0–53.0) at 5-years. Around 9% met criteria for ICD-10 opioid dependence at each wave. In adjusted mixed effect models, the risk factors most consistently associated with problematic opioid use were: younger age, substance dependence, mental health histories and higher opioid doses. Interpretation: Both patient risk factors and opioid dose are associated with problematic opioid use behaviours.

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Title: Risk factors for indicators of opioid-related harms amongst people living with chronic non-cancer pain: Findings from a 5-year prospective cohort study
Authors: Gabrielle Campbell (Author) - University of the Sunshine Coast, Queensland, School of Health and Sport Sciences - Legacy
Firouzeh Noghrehchi (Author) - The University of Sydney
Suzanne Nielsen (Author) - UNSW Australia
Phillip Clare (Author) - UNSW Australia
Raimondo Bruno (Author) - University of Tasmania
Nicholas Lintzeris (Author) - The University of Sydney
Milton Cohen (Author) - St Vincent's Hospital Sydney
Fiona Blyth (Author) - The University of Sydney
Wayne D Hall (Author) - The University of Queensland
Briony Larance (Author) - UNSW Australia
Phillip Hungerford (Author) - UNSW Australia
Timothy Dobbins (Author) - UNSW Australia
Michael Farrell (Author) - UNSW Australia
Louisa Degenhardt (Author) - UNSW Australia
Publication details: EClinicalMedicine, Vol.28, 100592
Publisher: Elsevier Ltd.
Date published: 2020
DOI: 10.1016/j.eclinm.2020.100592
ISSN: 2589-5370
Copyright note: (c) 2020 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Organisation Unit: University of the Sunshine Coast, Queensland; School of Health and Sport Sciences - Legacy; School of Health and Behavioural Sciences - Legacy
Language: English
Record Identifier: 99484008102621
Output Type: Journal article

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