University Of Tasmania
142452-Risk factors for indicators of opioid-related harms amongst people living.pdf (1.09 MB)
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Risk factors for indicators of opioid-related harms amongst people living with chronic non-cancer pain: findings from a 5-year prospective cohort study

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posted on 2023-05-20, 20:23 authored by Campbell, G, Noghrehchi, F, Nielsen, S, Clare, P, Raimondo BrunoRaimondo Bruno, Lintzeris, N, Cohen, M, Blyth, F, Hall, W, Larance, B, Hungerford, P, Dobbins, T, Farrell, M, Degenhardt, L
Background: The literature suggests patient characteristics and higher opioid doses and long-term duration are associated with problematic opioid behaviours but no one study has examined the role of all these factors simultaneously in a long-term prospective cohort study.

Methods: Five-year, community-based, prospective cohort of people prescribed opioids for chronic non-cancer pain (CNCP). Logistic mixed effect models with multiple imputation were used to address missing data. Oral morphine equivalent (OME) mg per day was categorised as: 0 mg OME/day, 1-49 mg OME/day (reference), 50-89 mg OME/day, 90-199 mg OME/day and 200mg+ OME/day. Patient risk factors included: age, gender, substance use, mental health history and pain-related factors. Main outcomes included: Prescribed Opioids Difficulties Scale (PODS), Opioid-Related Behaviours In Treatment (ORBIT) scale, and ICD-10 opioid dependence. Multiple confounders for problematic opioid behaviours were assessed.

Findings: Of 1,514 participants 44.4% weremale (95%CI 41.9-46.9) and theirmean agewas 58 years (IQR 48-67). Participants had a mean duration of pain of 10 years (IQR 4.5-20.0) and had been taking strong opioids for a median of four years (IQR 1.0-10.0). At baseline, median OME/day was 73 (IQR 35-148). At 5-years, 85% were still taking strong opioids. PODS moderate-high scores reduced from 59.9% (95%CI 58.8-61.0) at baseline to 51.5% (95%CI 50.0-53.0) at 5-years. Around 9% met criteria for ICD-10 opioid dependence at each wave. In adjusted mixed effect models, the risk factors most consistently associated with problematic opioid use were: younger age, substance dependence, mental health histories and higher opioid doses.

Interpretation: Both patient risk factors and opioid dose are associatedwith problematic opioid use behaviours.


National Health & Medical Research Council


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School of Psychological Sciences


Elsevier Ltd

Place of publication

United Kingdom

Rights statement

Copyright 2020 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license

Repository Status

  • Open

Socio-economic Objectives

Substance abuse