Unlike alcohol and drug addiction, it can be difficult to identify those who are addicted to prescription drugs. In an effort to make it easier for doctors and healthcare professionals to screen for prescription drug use disorder (PDUD) in patients with chronic pain, researchers at the Boston University School of Medicine (BUSM) conducted a study that appears in the Journal of Pain. Over the past decade, more and more doctors are prescribing opioid medication for those with chronic pain, such as Vicodin and OxyContin. Many physicians are apprehensive about prescribing these drugs because of their high incidence of abuse, and because some patients request the medication because they’re dependent on them. The BUSM researchers wanted to examine the clinical characteristics of people who suffer from chronic pain who are addicted to opioid medication. To do so, they compared these individuals with people who had other substance abuse disorders and still others who had no history of substance abuse disorders. Participants had experienced chronic pain for more than three months and had used prescription or non-prescription medication. The researchers discovered that 18 percent of the almost 600 participants had PDUD, and 90 percent were addicted to another substance. Fifty-seven percent had no history of a substance abuse disorder, and more than 24 percent had a substance abuse disorder other than PDUD. Only 60 of the participants were female, and 60 percent were of African descent. The study found that many factors were associated with PDUD, including cigarette smoking, severe pain, family history of substance abuse, having spent time in jail, having post-traumatic stress disorder, and being male and white. The same factors were also involved in those who had other substance abuse problems, except for race. In this sample, insurance, employment, income, education, and age were not associated with any type of substance abuse disorders. Time spent in jail was the largest predictor of abusing prescription drugs, according to lead author Jane M. Liebschutz, MD, MPH, FACP, an associate professor of medicine and social and behavioral sciences at BUSM and a physician at Boston Medical Center. Dr. Liebschutz said the data strongly suggests that physicians treating patients with chronic pain should screen for substance abuse disorders before prescribing opioid medications. She added that this research may help physicians treat for prescription drug abuse and other substance abuse disorders. Source: Eurekalert, Researchers Define Traits Associated with Prescription Drug Disorders in a Primary Care Setting, May 14, 2010.
