• Shushovan Chakrabortty, Deepak Gupta, David Rustom, Hussein Berry, and Ajit Rai.
• Clinical Assistant Professor, Department of Anesthesiology and Pain Medicine, Detroit Medical Center, Wayne State University, Detroit, Michigan.
• J Opioid Manag. 2014 Nov 1; 10 (6): 405-14.

ObjectiveThe current retrospective study was completed with the aim to identify demographic characteristics and clinical predictors (if any) of the patients discharged from our pain clinic due to breach in narcotic use contract (BNUC).DesignRetrospective patient charts' review and data audit.SettingUniversity hospital-affiliated pain clinic in the United States.ParticipantsAll patient charts in our pain clinic for a 2-year period (2011-2012).InterventionsThe patients with BNUC were delineated from the patients who had not been discharged from our pain clinic.Main Outcome MeasuresPain characteristics, pain management, and substance abuse status were compared in each patient with BNUC between the time of admission and the time of discharge.ResultsThe patients with BNUC discharges showed significant variability for the discharging factors among the pain physicians within a single pain clinic model with this variability being dependent on their years of experience and their proactive interventional pain management. The patients with BNUC in our pain clinic setting were primarily middle-aged, obese, unmarried males with nondocumented stable occupational history who were receiving only noninterventional pain management. Substance abuse, doctor shopping, and potential diversion were the top three documented reasons for BNUC discharges.ConclusionIn 2011-2012, our pain clinic discharged 1-in-16 patients due to breach in narcotic use contract.

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