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Predictors of Resolution of Aberrant Drug Behavior in Chronic Pain Patients Treated in a Structured Opioid Risk Management Program
Journal article   Open access   Peer reviewed

Predictors of Resolution of Aberrant Drug Behavior in Chronic Pain Patients Treated in a Structured Opioid Risk Management Program

Salimah H. Meghani, Nancy L. Wiedemer, William C. Becker, Ed J. Gracely and Rollin M. Gallagher
Pain medicine (Malden, Mass.), v 10(5), pp 858-865
01 Jul 2009
DOI: https://doi.org/10.1111/j.1526-4637.2009.00643.x
PMID: 19523029
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1111/j.1526-4637.2009.00643.xView
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open

Abstract

Anesthesiology General & Internal Medicine Life Sciences & Biomedicine Medicine, General & Internal Science & Technology
Objective. To identify demographic and clinical predictors of the resolution of aberrant drug-related behaviors (ADRBs) in a group of patients referred to the Opioid Renewal Clinic (ORC) by their primary care providers (PCPs). ORC is a program supporting PCPs' use of opioids for chronic pain in patients perceived as at risk for opioid abuse or those with demonstrated ADRBs. Methods. A retrospective chart review was conducted for 195 consecutive subjects referred to the ORC from January 17, 2002 to August 27, 2004, for ADRBs. Binary logistic regression was employed to identify independent predictors of aberrant behavior outcome at 1 year. Results. Of the 195 referred, 45.6% (N = 89) resolved their ADRB at 1 year. Other outcomes, classified as nonresolution of ADRB, self-discharged or discharged by the ORC for inability to adhere to the opioid treatment agreement (N = 86, 44.1%) and acceptance of referral for addiction treatment (N = 20, 10.2%). A history of cocaine abuse increased the odds of failing the program by five times (odds ratio [OR] = 4.97, P = 0.001). Each additional pain diagnosis reduced the odds of failure by 16% (OR = 0.837, P = 0.008). When compared with singles, married individuals were 62% less likely to fail the ORC program (OR = 0.38, P = 0.028). Conclusions. Nearly half of the patients resolved their aberrant behavior within the ORC. Patients with cocaine abuse were at higher risk for failure, suggesting a need for further research into safe and effective ways to manage pain in this complex subset of patients. Aberrant behaviors tended to resolve in patients with multiple pain locations, possibly because of their desire for relief.

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17 citations in Web of Science
28 citations in Scopus

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Collaboration types
Domestic collaboration
Web of Science research areas
Anesthesiology
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