title: Demographic characteristics and clinical predictors of patients discharged from university hospital-affiliated pain clinic due to breach in narcotic use contract.
abstract: OBJECTIVE
  The current retrospective study was completed with the aim to identify demographic characteristics and clinical predictors (if any) of the patients discharged from our pain clinic due to breach in narcotic use contract (BNUC).
  
  
  METHODS
  Retrospective patient charts' review and data audit.
  
  
  METHODS
  University hospital-affiliated pain clinic in the United States.
  
  
  METHODS
  All patient charts in our pain clinic for a 2-year period (2011-2012).
  
  
  METHODS
  The patients with BNUC were delineated from the patients who had not been discharged from our pain clinic.
  
  
  METHODS
  Pain characteristics, pain management, and substance abuse status were compared in each patient with BNUC between the time of admission and the time of discharge.
  
  
  RESULTS
  The patients with BNUC discharges showed significant variability for the discharging factors among the pain physicians within a single pain clinic model with this variability being dependent on their years of experience and their proactive interventional pain management. The patients with BNUC in our pain clinic setting were primarily middle-aged, obese, unmarried males with nondocumented stable occupational history who were receiving only noninterventional pain management. Substance abuse, doctor shopping, and potential diversion were the top three documented reasons for BNUC discharges.
  
  
  CONCLUSIONS
  In 2011-2012, our pain clinic discharged 1-in-16 patients due to breach in narcotic use contract.
authors.affiliation: Clinical Assistant Professor, Department of Anesthesiology and Pain Medicine, Detroit Medical Center, Wayne State University, Detroit, Michigan.
authors.forename: Shushovan
authors.initials: S
authors.lastname: Chakrabortty
authors.affiliation: Clinical Assistant Professor, Department of Anesthesiology and Pain Medicine, Detroit Medical Center, Wayne State University, Detroit, Michigan.
authors.forename: Deepak
authors.initials: D
authors.lastname: Gupta
authors.affiliation: Resident, Department of Physical Medicine and Rehabilitation, Detroit Medical Center, Wayne State University, Detroit, Michigan.
authors.forename: David
authors.initials: D
authors.lastname: Rustom
authors.affiliation: Graduate Student, Department of Anesthesiology and Pain Medicine, Detroit Medical Center, Wayne State University, Detroit, Michigan.
authors.forename: Hussein
authors.initials: H
authors.lastname: Berry
authors.affiliation: Medical Student, Department of Anesthesiology and Pain Medicine, Detroit Medical Center, Wayne State University, Detroit, Michigan.
authors.forename: Ajit
authors.initials: A
authors.lastname: Rai
mesh_terms: D000328:Adult; D000367:Age Factors; D000701:Analgesics, Opioid / Q000009:adverse effects*; D032982:Contracts; D004651:Employment; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy*; D018710:Pain Clinics; D010349:Patient Compliance; D010351:Patient Discharge; D063487:Prescription Drug Misuse / Q000517:prevention & control / Q000523:psychology; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012847:Single Person; D013997:Time Factors
chemical_list: D000701:Analgesics, Opioid