Clinical Factors Associated With Prescription Drug Use Disorder in Urban Primary Care Patients with Chronic Pain

This study examined characteristics associated with prescription drug use disorder (PDUD) in primary care patients with chronic pain from a cross sectional survey conducted at an urban academically affiliated safety net hospital Participants were 18 to 60 years old had pain for >= 3 months took prescription or nonprescription analgesics and spoke English Measurements included the Composite International Diagnostic Interview (PDUD other substance use disorders (SUD) Posttraumatic Stress Disorder [PTSD]) Graded Chronic Pain Scale smoking status family history of SUD and time spent in jail Of 597 patients (41% male 61% black mean age 46 years) 110 (18 4%) had PDUD of whom 99 (90%) had another SUD In adjusted analyses those with PDUD were more likely than those without any current or past SUD to report jail time (OR 5 1 95% Cl 2 8-9 3) family history of SUD (OR 3 4 1 9 6) greater pain related limitations (OR 3 8 1 2 11 7) cigarette smoking (OR 3 6 2-6 2) or to be white (OR 3 2 1 7-6) male (OR 1 9 1 1-3 5) or have PTSD (OR 1 9 1 1-3 4) PDUD appears in creased among those with easily identifiable characteristics The challenge is to determine who among those with risk factors can avoid with proper management developing the increasingly common diagnosis of PDUD Perspective This article examines risk factors for prescription drug use disorder (PDUD) among a sample of primary care patients with chronic pain at an urban academic safety net hospital The findings may help clinicians identify those most at risk for developing PDUD when developing appropriate treatment plans (C) 2010 by the American Pain Society