PT - JOURNAL ARTICLE AU - Richard A. Deyo AU - David H. M. Smith AU - Eric S. Johnson AU - Marilee Donovan AU - Carrie J. Tillotson AU - Xiuhai Yang AU - Amanda F. Petrik AU - Steven K. Dobscha TI - Opioids for Back Pain Patients: Primary Care Prescribing Patterns and Use of Services AID - 10.3122/jabfm.2011.06.100232 DP - 2011 Nov 01 TA - The Journal of the American Board of Family Medicine PG - 717--727 VI - 24 IP - 6 4099 - http://www.jabfm.org/content/24/6/717.short 4100 - http://www.jabfm.org/content/24/6/717.full SO - J Am Board Fam Med2011 Nov 01; 24 AB - Background: Opioid prescribing for noncancer pain has increased dramatically. We examined whether the prevalence of unhealthy lifestyles, psychologic distress, health care utilization, and co-prescribing of sedative-hypnotics increased with increasing duration of prescription opioid use. Methods: We analyzed electronic data for 6 months before and after an index visit for back pain in a managed care plan. Use of opioids was characterized as “none,” “acute” (≤90 days), “episodic,” or “long term.” Associations with lifestyle factors, psychologic distress, and utilization were adjusted for demographics and comorbidity. Results: There were 26,014 eligible patients. Of these, 61% received a course of opioids, and 19% were long-term users. Psychologic distress, unhealthy lifestyles, and utilization were associated incrementally with duration of opioid prescription, not just with chronic use. Among long-term opioid users, 59% received only short-acting drugs; 39% received both long- and short-acting drugs; and 44% received a sedative-hypnotic. Of those with any opioid use, 36% had an emergency visit. Conclusions: Prescription of opioids was common among patients with back pain. The prevalence of psychologic distress, unhealthy lifestyles, and health care utilization increased incrementally with duration of use. Coprescribing sedative-hypnotics was common. These data may help in predicting long-term opioid use and improving the safety of opioid prescribing.