Boscarino et al reported risk factors for drug dependency for an outpatient with noncancer pain treated with opioids. These can help to identify a patient who may benefit from closer monitoring or an alternative therapy. The authors are from Geisinger Health System, Mount Sinai School of Medicine, Temple University and the Johns Hopkins University.

Patient selection: noncancer pain treated with opioids


Risk factors for drug dependency:

(1) age < 65 years

(2) depression

(3) therapy with psychotropic medications (anxiolytics, antidepressants, mood stabilizers, stimulants, antipsychotic agents)

(4) pain interferes with life or work

(5) history of severe dependency (by the Addiction Severity Index)

(6) history of opioid abuse


If all of these factors are present then the odds ratio for opioid dependence is 56.


A patient with opioid dependence also tends to have a high number of opioid prescriptions.

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