An observational study on the prevalence and pattern of opioid use in 25,479 patients with spine and radicular pain.
METHODS
A cross-sectional analysis of data obtained from patients with spinal and radicular pain and their spine center treating physicians was performed.


OBJECTIVE
To identify characteristics of patients treated with opioids that distinguish them from similar patients not treated with opioids in a large population of patients with spine and radicular pain, and to determine the prevalence of opioid use.


BACKGROUND
The use of opioids with patients who have chronic pain remains controversial. The long-term risks and benefits are poorly described. The efficacy of this treatment has not been proved, yet the large majority of pain specialist physicians manage chronic pain with opioids.


METHODS
Descriptive data from the initial visits of 25,479 patients with spinal pain were reviewed. Patients were grouped according to whether or not opioids were recommended, prescribed, or continued. The prevalence of opioid use and patient characteristics were compared using standard statistical tests.


RESULTS
Overall, 3.4% of the patients had opioids included in their plan of care. There was no difference in age, gender, education, or compensation status between the two groups. Patients were more likely to be treated if the duration of their symptoms had been less than 3 months. However, 75% of the patients with opioids in their plan had experienced symptoms longer than 3 months. A greater incidence of objective findings was identified in the opioid group.


CONCLUSIONS
The authors cannot comment on the prevalence of opioid use because, to the best of their knowledge, no other similar studies are available for comparison.
Fanciullo
Gilbert J
GJ
Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA. Gilbert.J.Fanciullo@Hitchcock.org
Ball
Perry A
PA
Girault
Gisele
G
Rose
Robert J
RJ
Hanscom
Brett
B
Weinstein
James N
JN
D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000639:trends; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000009:adverse effects / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy* / Q000453:epidemiology; D018710:Pain Clinics; D015995:Prevalence; D011843:Radiculopathy / Q000188:drug therapy* / Q000453:epidemiology; D013122:Spinal Diseases / Q000188:drug therapy* / Q000453:epidemiology; D011795:Surveys and Questionnaires
D009294:Narcotics