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Unintended prolonged opioid use: a prospective case-control study.

W Michael Hooten1, Darin J Erickson2, Marek Chawarski3

  • 1Division of Pain Medicine, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States.

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Summary
This summary is machine-generated.

Opioid-naive adults may develop unintended prolonged opioid use (UPOU), linked to health risks. This study identified patient factors predicting UPOU, aiding early intervention strategies.

Keywords:
Case–controlNew persistent opioid useProlonged opioid useProspectiveUnanticipated opioid use

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Area of Science:

  • Pain Management
  • Addiction Medicine
  • Public Health

Background:

  • Short-term opioid prescriptions can lead to unintended prolonged opioid use (UPOU).
  • UPOU is a significant public health concern, associated with increased morbidity and mortality.
  • Identifying risk factors for UPOU is crucial for developing targeted interventions.

Purpose of the Study:

  • To identify incident cases of unintended prolonged opioid use (UPOU) in opioid-naive adults.
  • To compare characteristics of patients who progressed to UPOU with those who did not.
  • To inform strategies for identifying and intervening with at-risk patients.

Main Methods:

  • Prospective case-control study design.
  • Recruitment of opioid-naive adults receiving initial opioid prescriptions across 3 clinical sites.
  • Verification of opioid use status via urine drug tests at 90 days post-prescription.

Main Results:

  • Factors associated with UPOU included prior emergency department visits, specific surgeries, smoking status, daily OTC pain medication use, opioid craving, and pain interference.
  • Factors negatively associated with UPOU included postsurgical pain indication, prior pregnancy, widespread body pain, and lower general activity levels.
  • The study analyzed 513 cases and 517 controls, with a mean age of 49.6 years and 67.4% female participants.

Conclusions:

  • Novel insights into behavioral pain responses and patient characteristics linked to UPOU were identified.
  • Findings can guide the development of strategies to identify patients at risk for UPOU.
  • Interventions targeting modifiable risk factors for UPOU can be deployed based on these results.