title: Opioid Overdose History, Risk Behaviors, and Knowledge in Patients Taking Prescribed Opioids for Chronic Pain.
abstract: OBJECTIVE
  More than 100 million adults in the United States experience chronic pain, and prescription opioids are the third most widely prescribed class of medications. Current opioid overdose prevention efforts almost exclusively target illicit opioid users, and little is known about the experience of overdose among patients being treated for chronic pain (CP) with a prescription opioid.
  
  
  METHODS
  Patients experiencing CP for three or more months and receiving a prescription opioid for pain management (N = 502) completed a self-report survey that asked questions about opioid overdose history, past 30-day risk factors, and knowledge of opioid overdose, overdose risk, and naloxone.
  
  
  RESULTS
  Approximately one in five CP participants reported experiencing a lifetime overdose. CP participants reported engaging in several behaviors associated with overdose risk and were unlikely to have been trained to administer naloxone. Fewer than 50% of participants answered any knowledge item correctly. The likelihood of having experienced an overdose increased as the scores on the SOAPP-R and DSM-5 opioid use disorder checklist increased, and a SOAPP-R score of 7 or higher or meeting DSM-5 mild opioid use disorder criteria were significantly associated with reporting a lifetime overdose (85% and 84% of participants who experienced an overdose, respectively).
  
  
  CONCLUSIONS
  Opioid overdose occurs at a high rate among CP participants, and this group is relatively uninformed about risk factors for overdose. Established SOAPP-R and DSM thresholds provide an opportunity to identify participants at elevated risk for having experienced an opioid overdose. These data support development of additional concentrated efforts to prevent overdose among chronic pain patients.
authors.affiliation: Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine Baltimore, MD, USA.
authors.forename: Kelly E
authors.initials: KE
authors.lastname: Dunn
authors.affiliation: Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine Baltimore, MD, USA.
authors.forename: Frederick S
authors.initials: FS
authors.lastname: Barrett
authors.affiliation: Department of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA 21224.
authors.forename: Michael
authors.initials: M
authors.lastname: Fingerhood
authors.affiliation: Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine Baltimore, MD, USA.
authors.forename: George E
authors.initials: GE
authors.lastname: Bigelow
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy*; D062787:Drug Overdose / Q000453:epidemiology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012309:Risk-Taking; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D000701:Analgesics, Opioid