• Pain Med · Aug 2014

    Screening for current opioid misuse and associated risk factors among patients with chronic nonalcoholic pancreatitis pain.

    • Kelly S Barth, Wendy Balliet, Christine M Pelic, Alok Madan, Robert Malcolm, David Adams, Katherine Morgan, Stefanie Owczarski, and Jeffrey J Borckardt.
    • Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.
    • Pain Med. 2014 Aug 1; 15 (8): 1359-64.

    ObjectiveThe objective of this study is to assess clinical variables that may be associated with risk for opioid misuse in individuals with chronic pancreatitis.DesignThis study utilized a descriptive, quasi-experimental, cross sectional design.Setting And PatientsThree hundred seven individuals with nonalcoholic chronic pancreatitis engaged in chronic opioid therapy for pain presented to an outpatient specialty clinic at an academic medical center.MeasuresParticipants completed the Current Opioid Misuse Measure (COMM), Brief Pain Inventory (BPI), Short Form (SF)-12 Quality of Life Measure, Center for Epidemiological Studies 10-item Depression Scale (CESD), and a single item asking about current alcohol use. Mean scores on the CESD, COMM, BPI, SF-12, and factors associated with opioid misuse measures from regression analyses were the outcome measures.ResultsMean scores on the CESD, COMM, BPI pain-on-average item, and the SF-12 physical and psychological quality of life factors (t scores) were 11.2 (standard deviation [SD] = 6.7), 8.5 (SD = 7.3), 4.8 (SD = 2.8), 39.7 (SD = 7.0), and 45 (SD = 9.0), respectively. Descriptive analyses revealed that 55% of participants scored above the clinical cutoff for depression on the CESD, and 39% scored above the cutoff for opioid misuse concerns on the COMM. Regression analyses identified several factors associated with higher opioid misuse measure scores, including increased depressive symptoms from the CESD (β = 0.38, P < 0.0001), increased pain rating at the time of the office visit (β = 0.16, P = 0.03), impairment of psychological quality of life (β = -0.27, P = 0.001) and endorsement of alcohol use (β = 0.16, P = 0.03). These factors accounted for 37% of the variance in current opioid misuse scores.ConclusionsDepression, quality of life, pain intensity and alcohol use may be good candidate variables for prospective studies to determine clinical risk factors for opioid misuse among patients with pancreatitis.Wiley Periodicals, Inc.

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