title: Pain, substance use disorders and opioid analgesic prescription patterns in veterans with hepatitis C.
abstract: To examine the prevalence of pain, substance use disorder (SUD) diagnoses, and opioid analgesic prescription patterns among veterans infected with the hepatitis C virus (HCV), a retrospective review of the medical records of 8,224 HCV-positive (HCV+) veterans was performed. Twenty-nine percent and 46% of HCV+ patients were prescribed opioids in the prior one and three years, respectively. Sixty-seven percent of HCV+ patients had documented pain diagnoses and 56% had SUD diagnoses. Patients with co-occurring pain and SUD were less likely to be prescribed opioids than patients with pain only (prior year: 36% vs. 43%, P<0.001; three years: 56% vs. 60%, P<0.01). There were no differences in numbers of early opioid prescription fills or numbers of opioid prescribers when comparing patients with co-occurring pain and SUD to patients with pain only. Veterans with co-occurring pain and opioid use disorder had fewer early opioid fills than veterans with pain only (prior year: 2.6 vs. 5.3 days, P<0.01; three years: 6.1 vs. 13.4 days, P<0.001). These data demonstrate that pain and SUD diagnoses were common among HCV+ patients, and that opioids were frequently prescribed. Co-occurring SUD was not associated with indicators of prescription opioid misuse.
authors: Northwest Hepatitis C Resource Center, Portland, OR, USA. ashlee.whitehead@va.gov
authors: Ashlee J
authors: AJ
authors: Whitehead
authors: Steven K
authors: SK
authors: Dobscha
authors: Benjamin J
authors: BJ
authors: Morasco
authors: Samantha
authors: S
authors: Ruimy
authors: Cara
authors: C
authors: Bussell
authors: Peter
authors: P
authors: Hauser
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage*; D015897:Comorbidity; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006526:Hepatitis C / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D010146:Pain / Q000188:drug therapy* / Q000453:epidemiology*; D015995:Prevalence; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000517:prevention & control; D014481:United States / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid