Attitudes and Beliefs of Working and Work-Disabled People with Chronic Pain Prescribed Long-Term Opioids.
OBJECTIVE
This study was designed to gain insight into the apparent contradiction between the perspectives of researchers and policy makers, who have questioned the efficacy and safety of chronic opioid therapy for non-cancer pain patients, and the patients themselves, who often indicate that the therapy has value.


METHODS
A convenience sample of 54 patients on chronic opioid therapy was studied.


METHODS
Participants completed a questionnaire specifically designed for the study, and also several standard instruments that addressed functional interference, emotional functioning, and possible misuse of opioids. Their treating physicians rated the participants on the severity of their disability and the success of their opioid therapy.


RESULTS
Although participants reported significant ongoing pain, they gave positive global ratings to their opioid therapy, and reported little concern about addiction or side effects of opioids. They strongly endorsed the beliefs that opioids helped them control their pain and allowed them to participate in important activities such as work. They expressed the belief that their pain would be severe if they did not have access to opioids, and reported negative experiences with tapering or discontinuing opioids in the past. Work-disabled participants reported higher levels of affective distress, catastrophizing, and functional interference than working participants, and were judged by their physicians to be relatively less successful in managing their pain.


CONCLUSIONS
The results of this study suggest several tentative hypotheses about why patients on chronic opioid therapy value opioids, and identified several areas for systematic investigation in the future.
Department of Rehabilitation Medicine, Outcomes Research, Bethesda, Maryland.
James P
JP
Robinson
Evidera, Outcomes Research, Seattle, Washington.
Elizabeth J
EJ
Dansie
Evidera, Outcomes Research, Seattle, Washington.
Hilary D
HD
Wilson
Department of Anesthesiology and Pain Medicine and Center for Pain Research on Impact, Measurement, & Effectiveness (C-PRIME), University of Washington.
Suzanne
S
Rapp
Department of Anesthesiology and Pain Medicine and Center for Pain Research on Impact, Measurement, & Effectiveness (C-PRIME), University of Washington.
Dennis C
DC
Turk
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D059350:Chronic Pain / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000209:etiology*; D010820:Physicians / Q000523:psychology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D000701:Analgesics, Opioid
Beliefs; Long-Term Opioid Therapy; Misuse; Opioids