Opioid Addiction in Primary Care Chronic Pain Patients

Key DFM Personnel

Michael Fleming, MD, MPH - Principal Investigator
Stacey Balousek, BS - Study Coordinator
Cindy Klessig, BA - Researcher/Interview Expert
Ellyn Stauffacher, BA - Researcher
Linda Norton, BA - Research Counselor
Donna Baranowski, BA - Research Counselor
Kimberly Bastic, BA - Researcher (Milwaukee)

Funding

National Institute on Drug Abuse (a division of the National Institute of Health)

Background

Non-malignant chronic pain is an increasingly common and complex clinical problem. Primary care physicians are being encouraged by patients, pain specialists, and policy makers to increase the use of chronic opioid therapy as a primary treatment for chronic pain. Some of the major concerns of both physicians and leaders of health care systems are the development of addiction, drug-seeking behavior, and diversion in patients receiving chronic opioid therapy.

Specific aims

The proposed study is designed to estimate the current and lifetime prevalence of drug use and dependence in patients receiving chronic narcotics from their primary care physicians. Drugs of interest include licit opioids, illicit opioids, sedatives, cocaine, stimulants, cannabis, and alcohol. Secondary questions of interest involve levels of pain control on narcotics, co-morbitiy issues, health status, and quality of life issues.

Methods

A prevalence study will be conducted in health care systems in Wisonsin. A sample of 1,000 patients will be recruited from the practices of approximately 200 primary care physicians. Inclusion criteria include taking prescription opioids for at least the past 30 days, age between 18 and 70, a diagnosis of chronic non-malignant pain, and narcotics prescribed by a primary care clinician. Face-to-face interviews will be conducted utilizing the SDSS and ASI to assess current and lifetime drug addiction. Patients will also complete questionnaires to assess the secondary questions of interest. The physicians will also participate in a short questionnaire to asses their current approach to the use of narcotics for chronic pain.

Summary

This would be the first large prevalence survey conducted in the US health care system to assess rates of addiction in a primary care chronic pain population.