Dynamic risk factors in the misuse of opioid analgesics.
OBJECTIVE
Identify the risk factors for prescription opioid misuse among patients taking prescription opioids to deal with chronic pain.


METHODS
We examined the literature for a variety of dynamic risk factors associated with opioid misuse among the chronic pain population in order to present a narrative review. Considered were: taking single or multiple opioids, pain intensity, mental health disorders, including a history of preadolescent sexual abuse, personal and familial history of substance abuse, a history of legal problems, being a crime victim, drug-seeking behaviors, drug craving, and age.


RESULTS
A variety of risk factors have been studied in the literature. Risk factors in chronic opioid therapy patients are dynamic in that they can change with disease progression, tolerance, changes in pain quality, mental health, comorbidities, other drug therapies or drug interactions, and changes in the patient's lifestyle.


CONCLUSIONS
Opioid analgesic therapy must be tailored to carefully monitor all patients in order to minimize misuse and abuse, since the risk is constant and dynamic and therefore every patient is at some degree of risk for opioid misuse.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Joseph V
JV
Pergolizzi
Christopher
C
Gharibo
Steven
S
Passik
Sumedha
S
Labhsetwar
Robert
R
Taylor
Jason S
JS
Pergolizzi
Gerhard
G
Müller-Schwefe
D000328:Adult; D000367:Age Factors; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D059350:Chronic Pain / Q000188:drug therapy / Q000523:psychology; D006801:Humans; D001523:Mental Disorders / Q000523:psychology; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000209:etiology* / Q000523:psychology; D010147:Pain Measurement; D012307:Risk Factors
D000701:Analgesics, Opioid