Patients receiving long-term opioid therapy often transitioned to chronic use (>90 days) after initiating opioids for short-term treatment of post-operative or injury-related pain, according to a study published online in The Journal of Pain.
Study authors sought to determine how chronic opioid therapy was started via a researcher-administered survey to chronic pain patients (n=115).
Surveyed patients reported that chronic opioid use often started after surgery (27%, 95% CI: 18.5–35.5) or for the treatment of acute injury-related pain (27%, 95% CI: 18.5–35.5). The continuation of opioids was attributed to follow-up corrective surgery that was required in many with injury-related pain (58.1%, 95% CI: 47.5–68.7); many who started opioids following surgery also reported post-op complications (61.3%, 95% CI: 50.8–71.8). The main prescribers were surgeons (30%), pain specialists (29%), and primary physicians (21%).
The survey also found 43.5% of patients had concurrent depression (95% CI: 34.0–53.0) and 23.5% had anxiety (95% CI: 15.3–31.7). A history of aberrant drug-related behavior and self-reported history of addiction were also seen in many study participants (32.5% and 21.7%, respectively). In addition, nearly 25% of patients reported taking opioids for a different indication than that for which the drugs were originally prescribed for (95% CI: 26.6–45.0).
“It is not evident if a clear decision to continue opioids on a chronic basis was made,” concluded study author Catherine E. Callinan, MSc, from Penn Pain Medicine Center, University of Pennsylvania. Findings from the survey shed more light into how chronic therapy is begun and “may suggest opportunities for improved patient selection for opioid therapy.”
For more information visit jpain.org.