Prescription opioid misuse in people with chronic noncancer pain: A multi-variable analysis of sociodemographic, clinical, and psychological factors

Abstract

Previous research has identified associations between sociodemographic, clinical, and psychological factors and prescription opioid misuse in individuals with chronic noncancer pain (CNCP). A two-study design was used to identify the factors with the most robust association with prescription opioid misuse (Study 1) and to cross-validate these associations in a second sample of people with CNCP to select a reduced number of variables (Study 2). Study 1 included 187 people with CNCP. Point biserial and bivariate correlations, and chi-square analysis showed that the variables significantly associated with opioid misuse were impulsiveness, anxiety sensitivity (AS), pain acceptance, pain catastrophizing, anxiety, depression, posttraumatic stress symptoms (PTSD), and social desirability (medium effect sizes). A family history of alcohol/drug abuse and being between 16 and 45 years of age also reached statistical significance. Study 2 included 179 people with CNCP. The results corroborated the associations found between opioid misuse and impulsiveness, AS, pain acceptance, pain catastrophizing, anxiety, depression, and PTSD. Logistic regression showed that AS, PTSD, and pain acceptance contributed significantly to the unique variance in prescription opioid misuse. Therefore, when prescribing opioids, clinicians should increase the supervision of those people with high AS, PTSD, and low pain acceptance. Evaluating these three variables in people with CNCP who are eligible for opioid therapy could aid in their therapeutic management and help prevent possible iatrogenic effects of opioids. Likewise, this could significantly enhance individual well-being and help mitigate the social problem associated with the misuse of prescription opioids.