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Substance Use Disorders in a Primary Care Sample Receiving Daily Opioid Therapy
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Unlabelled The primary goal of this paper was to present a comprehensive picture of substance use disorders in a sample of patients receiving opioid therapy from their primary care physician. A second goal was to determine the relation of positive urine screens and aberrant drug behaviors to opioid use disorders. The study recruited 801 adults receiving daily opioid therapy from the primary care practices of 235 family physicians and internists in 6 health care systems in Wisconsin. The 6 most common pain diagnoses were degenerative arthritis, low back pain, migraine headaches, neuropathy, and fibromyalgia. The point prevalence of current (DSM-IV criteria in the past 30 days) substance abuse and/or dependence was 9.7% (n=78) and 3.8% (30) for an opioid use disorder. A logistic regression model found that current substance use disorders were associated with age between 18 and 30 (OR=6.17: 1.99 to 19.12), severity of lifetime psychiatric disorders (OR=6.17; 1.99 to 19.12), a positive toxicology test for cocaine (OR=5.92; 2.60 to 13.50) or marijuana (OR=3.52; 1.85 to 6.73), and 4 aberrant drug behaviors (OR=11.48; 6.13 to 21.48). The final model for opioid use disorders was limited to aberrant behaviors (OR=48.27; 13.63 to 171.04) as the other variables dropped out of the model. Perspective This study found that the frequency of opioid use disorders was 4 times higher in patients receiving opioid therapy compared with general population samples (3.8% vs 0.9%). The study also pro…
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“It has been estimated that approximately 10% of individuals with chronic pain have active substance abuse and/or dependence18”
From Telehealth Versus In-Person Acceptance and Commitment Therapy for Chronic Pain: A Randomized Noninferiority Trial. (2017) · cites this paper as [18]
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Metadata
- Authors
- Fleming, M. F., Balousek, S. L., Klessig, C. L., Mundt, M. P., & Brown, D. D.
- Affiliations
- University of Wisconsin–Madison (US)
- University of British Columbia (CA)
- Corresponding author
- Fleming, Michael F.
- Venue
- The Journal of Pain
- Publisher
- Elsevier BV
- Published
- 2007-07
- Volume
- 8
- Issue
- 7
- Pages
- 573-582
- ISSN
- 1526-5900 (ISSN-L)
- PMC
- PMC1959336
- OpenAlex
- W2010125810
- Cited by
- 274
- References
- 50
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 8 · 2022: 8 · 2021: 10 · 2020: 13 · 2019: 16 · 2018: 14 · 2017: 22 · 2016: 15 · 2015: 17 · 2014: 19 · 2013: 19 · 2012: 20
- FWCI
- 22.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (T32AA014845)
- National Institute on Drug Abuse (R01DA013686)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- opioid use disorder, substance use disorders, primary care, cocaine use, cannabis use, psychiatric comorbidity, chronic pain
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Analgesics, Opioid, Marijuana Abuse, Chronic Disease, Drug Administration Schedule, Humans, Mass Screening, Middle Aged, Opioid-Related Disorders, Pain, Intractable, Intractable Pain, Physicians, Family, Risk Factors, Comorbidity, Causality, Prevalence, Logistic Models, Urinalysis, Substance-Related Disorders, Cocaine-Related Disorders
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