title: Pain management perceptions among prescription opioid dependent individuals.
abstract: BACKGROUND
  Nearly two-thirds of prescription opioid dependent individuals report chronic pain conditions as both an initial and current motivation for prescription opioid use. However, to date, limited information exists regarding perceptions of the adequacy of pain management and pain management behaviors among prescription opioid dependent individuals with a history of treatment for chronic pain.
  
  
  METHODS
  The current study examined perceptions of the medical management of chronic pain among community-recruited individuals (N=39) who met DSM-IV-TR criteria for current prescription opioid dependence and reported a history of treatment for chronic pain. Prescription opioid dependence, symptoms of depression, and pain management perceptions were assessed using the Structured Clinical Interview for DSM disorders, Beck Depression Inventory, and the Pain Management Questionnaire, respectively.
  
  
  RESULTS
  Reports of insufficient pain management were common (46.2%), as was utilization of emergency room services for pain management (56.4%). Nearly half reported a physician as their initial source (46.2%) and pain management as their primary initial reason for prescription opioid use (53.8%), whereas 35.9% reported pain relief as their primary reason for current prescription opioid use. Symptoms of depression were common (51.3%), as was comorbid abuse of other substances and history of treatment for substance abuse.
  
  
  CONCLUSIONS
  Results highlight the complicated clinical presentation and prevalent perception of the under-treatment of pain among this population. Findings underscore the importance of interdisciplinary approaches to managing the complex presentation of chronic pain patients with comorbid prescription opioid dependence. Implications for future research are discussed.
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States. Electronic address: mccaule@musc.edu.
authors.forename: Jenna L
authors.initials: JL
authors.lastname: McCauley
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.
authors.forename: Mary Ashley
authors.initials: MA
authors.lastname: Mercer
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States.
authors.forename: Kelly S
authors.initials: KS
authors.lastname: Barth
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States.
authors.forename: Kathleen T
authors.initials: KT
authors.lastname: Brady
authors.affiliation: Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, United States.
authors.forename: Sudie E
authors.initials: SE
authors.lastname: Back
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000523:psychology*; D010146:Pain / Q000188:drug therapy*; D059408:Pain Management / Q000523:psychology*; D010147:Pain Measurement; D010465:Perception; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid
keywords: Addictive behaviors; Pain management; Prescription opioid; Substance abuse