The Prescribed Opioids Difficulties Scale may be effective for identifying patients using opioids for chronic noncancer pain who are worried about their usage, according to a study recently published in Pain Medicine.
This study included 1086 individuals currently on prescribed opioids for chronic noncancer pain. Their characteristics, including help-seeking, were scored using the Prescribed Opioids Difficulties Scale. Those participants who scored between 17% and 30% on the scale (ie, intermediate to high), tended to be younger. Compared with those scoring lower on the scale, this group also reported using higher doses of opioids, worse physical health, significant depression and anxiety, abnormal behavior, more complex presentations of pain, as well as opioid use disorder and help-seeking within the past month. Approximately one-quarter of these participants had consulted a primary care physician, family member, partner, psychologist, counselor, pain specialist, or the internet for help.
Those with high Prescribed Opioids Difficulties Scale scores were more likely to have consulted an addiction specialist, a helpline for drugs, or a service for alcohol or drugs. Barriers to those seeking help included the wish to self-manage and a fear that seeking help might lead to discontinued opioid prescription. Although opioid use disorder was found to be likely in 35% of participants, only 4.8% indicated taking methadone or buprenorphine, which were found to be associated with perceived stigma.
Data for this study were collected from the Pain and Opioids IN Treatment (POINT) study, a cohort of 1514 individuals with opioids prescribed for chronic noncancer pain. Limitations include the fact that causality could not be determined due to the cross-sectional nature of the study.
“The [Prescribed Opioids Difficulties Scale is] a useful tool for identifying patients who are concerned about their opioid use. Primary care is an essential source of help and support for people who worry about their use of opioids. In particular, strategies to address stigma related to drug treatment that include better integration of primary health, specialist pain, and addiction services may be important in reducing opioid-related harm,” concluded the study authors.
Larance B, Campbell G, Moore T, et al. Concerns and help-seeking among patients using opioids for management of chronic noncancer pain [published online May 11, 2018]. Pain Med. doi: 10.1093/pm/pny078