title: Evaluation and comparison of tools for diagnosing problematic prescription opioid use among chronic pain patients.
abstract: Prescription opioid medications are commonly used for the treatment of chronic pain. Assessments of problematic opioid use among pain patients are inconsistent across studies, partially due to differences between various measures. Therefore, the most appropriate measure to use is often unclear. In this study we assessed problematic opioid use in a sample of 551 individuals receiving treatment for chronic pain, using three questionnaires: the Alcohol Use Disorder and Associated Disabilities Interview Schedule - Fourth Edition (AUDADIS-IV), the Current Opioid Misuse Measure (COMM) questionnaire and Portenoy's criteria (PC). These questionnaires yielded discordant positive rates of problematic use: 52.6%, 28.7%, and 17.1%, respectively, which did not change substantially when excluding AUDADIS-IV criteria of physical symptoms of tolerance and withdrawal. Although these three questionnaires share some statistically correlated content-based congruent questions, positive response rates to them were significantly different based on construction features, including questionnaires' referred time-frame, wording of questions and response alternatives. The findings of the present study illustrate strengths and limitations of the AUDADIS-IV, COMM and PC in diagnosing problematic opioid use in a population of adults suffering from chronic pain, and highlight the importance of recognizing and addressing specific questionnaire and question-related differences when identifying problematic opioid use in this population.
authors: Behavioral Sciences, Academic College of Tel Aviv-Jaffa, Tel Aviv, Israel.
authors: Merav
authors: M
authors: Kovatch
authors: Ariel University, Ariel, Israel.|Addiction Medicine and Dual Diagnosis Services, Department of Psychiatry, Sheba Medical Center, Tel Hashomer, Israel.
authors: Daniel
authors: D
authors: Feingold
authors: Behavioral Sciences, Academic College of Tel Aviv-Jaffa, Tel Aviv, Israel.
authors: Odelia
authors: O
authors: Elkana
authors: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Addiction Medicine and Dual Diagnosis Services, Department of Psychiatry, Sheba Medical Center, Tel Hashomer, Israel.
authors: Shaul
authors: S
authors: Lev-Ran
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000175:diagnosis*; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D019966:Substance-Related Disorders / Q000175:diagnosis*; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: chronic pain; opioid; prevalence; problematic use; questionnaires