Prescription opiate abuse in chronic pain patients : Clinical criteria, incidence, and predictors.
Opiates are commonly used to treat patients with chronic nonmalignant pain.
There is much controversy over the definition, incidence, and risk factors of prescription opiate abuse in chronic pain treatment.
The present study, done at the Seattle VA Medical Center, was designed to create opiate abuse criteria, test inter-rater reliability of the criteria, apply the criteria to a group of chronic pain patients, and correlate the risk of opiate abuse with the results of alcohol and drug testing.
A committee of experienced pain providers designed a five-point prescription opiate abuse checklist based on DSM-III-R parameters.
The criteria were then applied to patients enrolled in the pain clinic.
The reliability of the criteria were determined using two providers who were familiar with every patient in the clinic.
Drug, alcohol, and psychosocial testing were correlated with the risk of opiate abuse.
A total of 19% (76/403) of all pain clinic patients were using chronic opiates.
Thirty - four percent (26/76) met one, and 27.6% (21/76) met three or more of the abuse criteria.
The criteria had an inter-rater reliability of>0.9. There were no differences between chronic opiate users (n=76) and opiate abusers (n=21) for a history of drug or alcohol abuse or on psychosocial testing.
Prescription opiate abuse criteria for use in patients with chronic nonmalignant pain were designed. (...)
Mots-clés Pascal : Douleur, Chronique, Opiacés, Prescription médicale, Toxicomanie, Toxicité, Incidence, Chimiothérapie, Traitement, Homme, Epidémiologie, Pronostic, Prédiction, Facteur risque
Mots-clés Pascal anglais : Pain, Chronic, Opiates, Medical prescription, Drug addiction, Toxicity, Incidence, Chemotherapy, Treatment, Human, Epidemiology, Prognosis, Prediction, Risk factor
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0350952
Code Inist : 002B02B05. Création : 12/09/1997.