title: Risk factors associated with opioid medication misuse in community-dwelling older adults with chronic pain.
abstract: OBJECTIVE
  The aim of the study was to identify physical, psychological, and social risk factors associated with opioid medication misuse among community-dwelling older adults with chronic pain.
  
  
  METHODS
  Using a cross-sectional research design, a confidential survey was administered at 11 outpatient clinics affiliated with the Baltimore Veterans Affairs Medical Center and the University of Maryland Medical System. A sample of 163 older adults (response rate 80.7%) with chronic pain and receiving opioid medications provided demographic information and responded to survey items. Severity of pain, alcohol problems, physical disability, depressive symptoms, spirituality, social support, and social network were assessed. Descriptive statistics and exploratory regression analyses were employed to determine factors independently associated with misuse.
  
  
  RESULTS
  Higher levels of pain severity and depressive symptoms, and lower physical disability scores were significantly associated with increased risk of opioid medication misuse. Alcohol problems, spirituality, social support, and social network were not associated with opioid medication misuse.
  
  
  CONCLUSIONS
  High pain intensity scores may indicate undertreatment of pain or may represent a rationalization to justify opioid medication use. Higher levels of depressive symptoms have been noted in the chronic pain population and may contribute to misuse of opioid medications for psychic effects. Less physically disabled persons are more likely to misuse opioid medications or older person receiving multiple medications may wish to avoid potential adverse drug effects. While there was an association between lower levels of disability and higher risk for opioid medication misuse, a causal relationship could not be determined.
authors.affiliation: Florida Atlantic University School of Social Work, Boca Raton, FL 33431, USA. jpark14@fau.edu
authors.forename: Juyoung
authors.initials: J
authors.lastname: Park
authors.forename: Robert
authors.initials: R
authors.lastname: Lavin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000009:adverse effects*; D002908:Chronic Disease; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008508:Medication Errors; D010146:Pain / Q000188:drug therapy* / Q000453:epidemiology*; D010147:Pain Measurement / Q000379:methods; D012111:Residence Characteristics; D012307:Risk Factors; D012720:Severity of Illness Index; D012944:Social Support; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires
chemical_list: D000701:Analgesics, Opioid