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Prescription opioid use duration and beliefs about pain and pain medication in primary care patients

Philip Day, PhD, Scott Secrest, MPH, Dawn Davis, MD, Joanne Salas, MPH, Carissa van den Berk-Clark, PhD, MSW, Neelima Kale, PhD, MD, MBA, Catherine Hearing, MPH, F. David Schneider, MD, MSPH, Jeffrey F. Scherrer, PhD, ARCHNet Investigators


Background: Patient beliefs about pain and opioids have been reported from qualitative data. To overcome limitations of unstructured assessments and small sample sizes, we determined if pain and pain medication beliefs varied by chronic pain status and opioid analgesic use (OAU) duration in primary care patients.

Methods: Cross-sectional survey data obtained in 2017 and 2018 from 735 patients 18 years of age. The eight-item Barriers Questionnaire (BQ) measured beliefs about pain and pain medication. Patients reported OAU and use of other pain treatments. Multiple linear regression models estimated the association between never OAU, 1-90 day OAU and >90 day OAU and each BQ item.

Results: Overall, respondents were 49.1 (±15.4) years old, 38.7 percent white, 28.4 percent African-American, 23.5 percent Hispanic, and 68.6 percent female. About one-third never used opioids, 41.8 percent had 1-90 day OAU, and 21.6 percent had > 90 day OAU. Multiple linear regression analyses showed that compared to never OAU, > 90 day OAU had lower average agreement that analgesics are addictive (β = 0.50; 95 percent CI: 0.96, 0.03), and 1-90 day OAU (β = 0.53; 95 percent CI: 0.96, 0.10) and > 90 OAU (β = 0.55; 95 percent CI: 1.04, 0.06) had lower average agreement that analgesics make people do or say embarrassing things.

Conclusions: Patients with chronic OAU reported less concern about addiction and opioid-related behavior change. Never users were most likely to agree that opioids are addictive. There continues to be a need to educate patients about opioid risks. Assessing patients' beliefs may identify patients at risk for chronic OAU.


chronic pain, opioids, primary care

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