RT Journal Article
SR Electronic
T1 Opioids for Back Pain Patients: Primary Care Prescribing Patterns and Use of Services
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 717
OP 727
DO 10.3122/jabfm.2011.06.100232
VO 24
IS 6
A1 Richard A. Deyo
A1 David H. M. Smith
A1 Eric S. Johnson
A1 Marilee Donovan
A1 Carrie J. Tillotson
A1 Xiuhai Yang
A1 Amanda F. Petrik
A1 Steven K. Dobscha
YR 2011
UL http://www.jabfm.org/content/24/6/717.abstract
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.