Screening for current opioid misuse and associated risk factors among patients with chronic nonalcoholic pancreatitis pain.
OBJECTIVE
The objective of this study is to assess clinical variables that may be associated with risk for opioid misuse in individuals with chronic pancreatitis.


METHODS
This study utilized a descriptive, quasi-experimental, cross sectional design.


METHODS
Three hundred seven individuals with nonalcoholic chronic pancreatitis engaged in chronic opioid therapy for pain presented to an outpatient specialty clinic at an academic medical center.


METHODS
Participants completed the Current Opioid Misuse Measure (COMM), Brief Pain Inventory (BPI), Short Form (SF)-12 Quality of Life Measure, Center for Epidemiological Studies 10-item Depression Scale (CESD), and a single item asking about current alcohol use. Mean scores on the CESD, COMM, BPI, SF-12, and factors associated with opioid misuse measures from regression analyses were the outcome measures.


RESULTS
Mean scores on the CESD, COMM, BPI pain-on-average item, and the SF-12 physical and psychological quality of life factors (t scores) were 11.2 (standard deviation [SD] = 6.7), 8.5 (SD = 7.3), 4.8 (SD = 2.8), 39.7 (SD = 7.0), and 45 (SD = 9.0), respectively. Descriptive analyses revealed that 55% of participants scored above the clinical cutoff for depression on the CESD, and 39% scored above the cutoff for opioid misuse concerns on the COMM. Regression analyses identified several factors associated with higher opioid misuse measure scores, including increased depressive symptoms from the CESD (β = 0.38, P < 0.0001), increased pain rating at the time of the office visit (β = 0.16, P = 0.03), impairment of psychological quality of life (β = -0.27, P = 0.001) and endorsement of alcohol use (β = 0.16, P = 0.03). These factors accounted for 37% of the variance in current opioid misuse scores.


CONCLUSIONS
Depression, quality of life, pain intensity and alcohol use may be good candidate variables for prospective studies to determine clinical risk factors for opioid misuse among patients with pancreatitis.
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.
Kelly S
KS
Barth
Wendy
W
Balliet
Christine M
CM
Pelic
Alok
A
Madan
Robert
R
Malcolm
David
D
Adams
Katherine
K
Morgan
Stefanie
S
Owczarski
Jeffrey J
JJ
Borckardt
D000701:Analgesics, Opioid / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000175:diagnosis* / Q000523:psychology; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D050500:Pancreatitis, Chronic / Q000150:complications / Q000188:drug therapy*; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires
D000701:Analgesics, Opioid
Opioids; Pain; Pancreatitis