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Concerns and Help-Seeking Among Patients Using Opioids for Management of Chronic Noncancer Pain

Larance, B, Campbell, G, Moore, T, Nielsen, S, Bruno, R ORCID: 0000-0001-6673-833X, Lintzeris, N, Cohen, M, Hall, W, Mattick, R, O'Donnell, C and Degenhardt, L 2018 , 'Concerns and Help-Seeking Among Patients Using Opioids for Management of Chronic Noncancer Pain' , Pain medicine , pp. 1-12 , doi: 10.1093/pm/pny078.

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Abstract

Background: The safety and efficacy of long-termopioid treatment for chronic noncancer pain(CNCP) remains controversial. This study examinedwhether patients who report problematic opioiduse sought help and/or perceived barriers tohelp-seeking.Methods: Data were collected from 1,086 peopleprescribed opioids for CNCP via a large prospectivecohort called the Pain and Opioids IN Treatment(POINT) study. Patients’ characteristics and helpseekingwere examined according to scores on thePrescribed Opioids Difficulties Scale (PODS).Results: Participants scoring “intermediate” (17%)or “high” (30%) on the PODS were younger andreported more complex pain presentations, higheropioid doses, poorer physical health, moderate tosevere anxiety and depression, aberrant behavior,past month opioid use disorder and help-seeking(compared with the “low” PODS group, 53%). Onequarter(26%) had sought help, most commonlyfrom a primary care physician, specialist pain clinic,family member/partner, counselor/psychologist,and the Internet. Participants in the “high” PODSgroup were more likely to have sought help from analcohol or other drug service, addiction specialist,or drug information helpline. Common barriers tohelp-seeking were desire for self-management andconcern that their opioid treatment may be discontinued.Although 35% met criteria for likely opioiduse disorder, only 4.8% reported lifetime treatmentwith methadone or buprenorphine; participants’ ratingsindicated significant perceived stigma associatedwith these medications.Conclusions: The PODS is effective in identifyingpatients who are concerned about their opioid use.Strategies to address stigma related to drug treatment,including better integration of primary health,specialist pain, and addiction services, are importantin reducing opioid-related harm.

Item Type: Article
Authors/Creators:Larance, B and Campbell, G and Moore, T and Nielsen, S and Bruno, R and Lintzeris, N and Cohen, M and Hall, W and Mattick, R and O'Donnell, C and Degenhardt, L
Keywords: ppioids, addiction, health care, persistent pain, chronic pain
Journal or Publication Title: Pain medicine
Publisher: Blackwell Publishing Inc
ISSN: 1526-2375
DOI / ID Number: 10.1093/pm/pny078
Copyright Information:

Copyright 2018 American Academy of Pain Medicine.

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