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Research ArticleOriginal Research

Problem Drug-related Behavior and Discontinuation of Opioids Following the Introduction of an Opioid Management Program

Lucinda A. Grande, Ellen Campbell Thompson, Margaret A. Au, Devin Sawyer, Laura-Mae Baldwin and Roger Rosenblatt
The Journal of the American Board of Family Medicine November 2016, 29 (6) 718-726; DOI: https://doi.org/10.3122/jabfm.2016.06.160073
Lucinda A. Grande
the Department of Family Medicine, University of Washington School of Medicine, Seattle (LAG, ECT, MAA, L-MB, RR); and Providence St. Peter Family Medicine, Olympia, WA (DS).
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Ellen Campbell Thompson
the Department of Family Medicine, University of Washington School of Medicine, Seattle (LAG, ECT, MAA, L-MB, RR); and Providence St. Peter Family Medicine, Olympia, WA (DS).
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Margaret A. Au
the Department of Family Medicine, University of Washington School of Medicine, Seattle (LAG, ECT, MAA, L-MB, RR); and Providence St. Peter Family Medicine, Olympia, WA (DS).
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Devin Sawyer
the Department of Family Medicine, University of Washington School of Medicine, Seattle (LAG, ECT, MAA, L-MB, RR); and Providence St. Peter Family Medicine, Olympia, WA (DS).
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Laura-Mae Baldwin
the Department of Family Medicine, University of Washington School of Medicine, Seattle (LAG, ECT, MAA, L-MB, RR); and Providence St. Peter Family Medicine, Olympia, WA (DS).
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Roger Rosenblatt
the Department of Family Medicine, University of Washington School of Medicine, Seattle (LAG, ECT, MAA, L-MB, RR); and Providence St. Peter Family Medicine, Olympia, WA (DS).
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Abstract

Purpose: Problem drug-related behavior (PDB) among patients on chronic opioid therapy may reflect an opioid use disorder. This study assessed PDB prevalence and the relationship between PDB and ongoing prescription of opioids at a primary care clinic that implemented a multifaceted opioid management program.

Methods: A chart review of patients in a chronic opioid registry assessed prevalence of different types of PDB over 2 years, and whether opioids were prescribed during the last 3 months of the 2-year study period among patients with different levels of PDB.

Results: Among 233 registry patients, 84.1% exhibited PDB; 45.5% exhibited ≥3 types of PDB. At the end of 2 years, most registry patients were still prescribed opioids, though patients with ≥3 types of PDB were less likely than those without PDB to be prescribed opioids (62.3% vs. 78.4%, P = 0.016).

Conclusions: PDB was pervasive in this population of patients on chronic opioid therapy. Those with the most PDB, and thus with the greatest likelihood of opioid use disorder and its social and medical consequences, were the least likely to be prescribed opioids by the clinic after 2 years. Given the rising rates of illicit opioid use in the U.S., it is important that clinics work closely with their patients who display PDB, systematically assess them for opioid use disorder, and offer evidence-based treatment.

  • Ambulatory Care Facilities
  • Analgesics
  • Opioid
  • Opioid-Related Disorders
  • Prevalence
  • Primary Health Care
  • Registries
  • Safety-Net Providers
  • Substance Abuse Detection
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The Journal of the American Board of Family     Medicine: 29 (6)
The Journal of the American Board of Family Medicine
Vol. 29, Issue 6
November-December 2016
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Problem Drug-related Behavior and Discontinuation of Opioids Following the Introduction of an Opioid Management Program
Lucinda A. Grande, Ellen Campbell Thompson, Margaret A. Au, Devin Sawyer, Laura-Mae Baldwin, Roger Rosenblatt
The Journal of the American Board of Family Medicine Nov 2016, 29 (6) 718-726; DOI: 10.3122/jabfm.2016.06.160073

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Problem Drug-related Behavior and Discontinuation of Opioids Following the Introduction of an Opioid Management Program
Lucinda A. Grande, Ellen Campbell Thompson, Margaret A. Au, Devin Sawyer, Laura-Mae Baldwin, Roger Rosenblatt
The Journal of the American Board of Family Medicine Nov 2016, 29 (6) 718-726; DOI: 10.3122/jabfm.2016.06.160073
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Keywords

  • Ambulatory Care Facilities
  • Analgesics
  • Opioid
  • Opioid-Related Disorders
  • Prevalence
  • Primary Health Care
  • Registries
  • Safety-Net Providers
  • Substance Abuse Detection

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