• Eriko Onishi, Jennifer Lucas, Tetsuro Maeno, and Steffani R Bailey.
• From the Department of Family Medicine, Oregon Health & Science University, Portland (EO, JL, SRB); Department of Primary Care and Medical Education, University of Tsukuba, Tsukuba, Japan (TM).
• J Am Board Fam Med. 2020 Nov 1; 33 (6): 858-870.

BackgroundThe prescription of opioids for acute pain may be a driving factor in chronic opioid abuse. We examined patients' characteristics associated with the expectation of the receipt of opioid prescriptions for acute pain control.MethodsA 1-time survey was administered to adult patients at family medicine clinics in the Pacific Northwest between November 2018 and January 2019. Logistic regression modeled adjusted odds of expecting an opioid prescription in ≥ 3 of the 4 dispositional acute pain scenarios by patient demographics, opioid use, past-week pain intensity and duration, past-week anxiety, and pain catastrophizing.ResultsThe survey was completed by 108 patients (62% female, 48% between 30 and 49 years of age, 75% non-Hispanic Whites). Most patients (71%) expected an opioid prescription in ≥ 1 of the 4 scenarios; 26% expected a prescription in ≥ 3 scenarios. Patients with higher levels of pain catastrophizing had more than 3 times greater odds of expecting opioids than those with lower pain catastrophizing (OR, 3.73; P = .032; 95% CI, 1.12-12.46); no other characteristics were statistically significant.ConclusionHigher pain catastrophizing was associated with increased odds of expecting opioids in dispositional acute pain scenarios in outpatient settings. Future studies can determine whether addressing pain catastrophizing reduces expectations of opioid prescribing for acute pain control. The finding that most patients expected opioid prescriptions in acute pain scenarios needs further exploration into other potential factors associated with these expectations. Evidence-based guidelines for condition-specific acute pain management are warranted for appropriate opioid prescribing and to guide treatment expectations.© Copyright 2020 by the American Board of Family Medicine.

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