• Eric L Garland and Matthew O Howard.
• Integrative Medicine, Huntsman Cancer Institute, University of Utah, 395 South, 1500 East, Salt Lake City, UT 84112, United States; College of Social Work & Huntsman Cancer Institute, University of Utah, 395 South, 1500 East, Salt Lake City, UT 84112, United States.
• Drug Alcohol Depend. 2014 Nov 1;144:283-7.

BackgroundSome chronic pain patients receiving long-term opioid analgesic pharmacotherapy are at risk for misusing opioids. Like other addictive behaviors, risk of opioid misuse may be signaled by an attentional bias (AB) towards drug-related cues. The purpose of this study was to examine opioid AB as a potential predictor of opioid misuse among chronic pain patients following behavioral treatment.MethodsChronic pain patients taking long-term opioid analgesics (n=47) completed a dot probe task designed to assess opioid AB, as well as self-report measures of opioid misuse and pain severity, and then participated in behavioral treatment. Regression analyses examined opioid AB and cue-elicited craving as predictors of opioid misuse at 3-month posttreatment follow-up.ResultsPatients who scored high on a measure of opioid misuse risk following treatment exhibited significantly greater opioid AB scores than patients at low risk for opioid misuse. Opioid AB for 200 ms cues and cue-elicited craving significantly predicted opioid misuse risk 20 weeks later, even after controlling for pre-treatment opioid dependence diagnosis, opioid misuse, and pain severity (Model R(2)=.50).ConclusionBiased initial attentional orienting to prescription opioid cues and cue-elicited craving may reliably signal future opioid misuse risk following treatment. These measures may therefore provide potential prognostic indicators of treatment outcome.Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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