Problematic opioid use has been linked to specific single risk factors such as patient characteristics, extended duration of use and increased doses, bu the simultaneous effects of these individual factors has not been specifically examined. Australian researchers have undertaken a five-year prospective cohort study to assess these factors in patients prescribed opioids for chronic non-cancer pain (CNCP). 1,514 patients (mean age 58 years [IQR 48-67]) were included in the study. The mean duration of pain was 10 years (IQR 4.5-20.0) and patients were using strong opioids for a median of 4 years (1.0-10.0). The median oral morphine equivalent (OME) was 73 mg/day (IQR 35-148) at baseline.

After five years, it was reported that 85% of patients were still taking strong opioids. Researchers assessed the Prescribed Opioids Difficulties Scale (PODS), where scores were reduced from 59.9% at baseline to 51.5% at five years. In addition, opioid dependence was assessed using the ICD-10 classification system, where 9% of patients met the dependence criteria at each time interval of the study. Patient characteristics most commonly associated with opioid misuse included younger age, history of substance dependence, history of mental health issues and increased opioid doses. These findings suggest that patient characteristics and opioid dosing may simultaneously have an effect on problematic opioid behaviours within the community. The full details of this study can be viewed here.

Contributed by AMSS Associate Isabella Singh