Research reported in The Journal of Pain showed there is significant linkage between non-opioid substance abuse disorders, such as misuse of alcohol and illegal drugs, and therapeutic opioid abuse. The Journal of Pain is the peer-reviewed publication of the American Pain Society.
Researchers from the Cleveland Clinic examined the incidence of therapeutic opioid abuse in a retrospective analysis of 199 patients treated for chronic non-cancer pain. The aim of the study was to examine the association of non-opioid substance abuse disorders, opioid dosage and therapeutic opioid abuse (TOA). The authors hypothesized that a history of non-opioid substance abuse disorders and increasing opioid dosages would be associated with increased likelihood for TOA.
Results of the analysis showed that 87 patients (44 percent) were diagnosed with TOA. For patients with no known history of substance abuse, the incidence of TOA was 25 percent, while it was 83 percent in those with a known history of substance abuse disorders.
The authors concluded their findings underscore the importance of gathering a comprehensive substance abuse history prior to administering opioid therapy for patients with chronic non-cancer pain. Special precautions, such as diligent monitoring and use of an enforced opioid contract, also should be taken when prescribing to a patient with a known substance abuse history.
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