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  1. Prescription opiate abuse in chronic pain patients : Clinical criteria, incidence, and predictors.

    Article - En anglais

    Objectives 

    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.

    Design/Outcome Measures 

    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.

    Results 

    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.

    Conclusions 

    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

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0350952

    Code Inist : 002B02B05. Création : 12/09/1997.