Description

Ives et al identified risk factors for opioid misuse in patients with chronic pain. This can help identify patients who may require closer monitoring during opioid therapy. The authors are from  the University of North Caroline at Chapel Hill.


Opioid misuse included indications suggesting drug diversion such as:

(1) negative urine tests for the prescribed opioid

(2) positive urine tests for cocaine and/or amphetamines (but not marijuana). I would also include detection of nonprescribed opiates.

 

Risk factors from multivariate analysis:

(1) history of alcohol misuse

(2) history of cocaine abuse (I would add amphetamine abuse)

(3) previous conviction for drug use or driving under the influence (DUI) found on background check.

 

Patients who misused were younger (mean 48 vs 54 years) but I am not sure how this could be used practically since the ranges overlap.


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