Characteristics of Pain Patients With Opioid-Use Disorder

Background“Nonmedical” (i.e., illicit) use of opioid analgesics has skyrocketed among the general population during the past decade, with similar increases observed among pain patients who take opioids by prescription.ObjectiveBecause 1 in 3 opioid-maintained pain patients may be affected, it is essential that healthcare providers learn more about this subpopulation as a first step toward improved detection, brief intervention, referral, and general management.MethodThe authors examined baseline data for 40 chronic-pain patients in a treatment trial targeting opioid analgesic abuse.ResultsAbuse-disorder patients were dysfunctional and had high rates of psychiatric disorders and troublesome personality traits. Providers characterized patients as manipulative, drug-seeking, and noncompliant; patients complained that they were pharmacologically undertreated and were considered “addicts.” Despite having severe pain and addiction, their average daily opioid dose was only 69% of that used to treat addiction in the same geographic region.ConclusionAbuse-disorder patients had a similar physical but worse psychiatric/personality presentation than other chronic-pain patients, which suggests the need for increased psychiatric involvement.