Patients Who Receive Opioids for Chronic Pain Are Inadequately Managed
Approximately 10% of primary-care patients with chronic noncancer pain (CNCP) have a current substance use disorder (SUD). Treatment guidelines recommend that patients with an SUD who are treated with opioids require more intensive monitoring and treatment. This study of 5814 Veterans Affairs patients prescribed opioids for 90 or more consecutive days in 2008 compared provider adherence to guideline-recommended practices among patients with and without an SUD diagnosis in the prior year.
- Twenty percent of patients prescribed opioids had an SUD.
- Patients with an SUD were more likely than those without to have had a mental health appointment (30% versus 17%) and a urine drug screen (47% versus 18%).
- There was no difference between groups in:
- primary-care follow-up ≥4 times per year (63% versus 61%),
- use of long-acting opioids (27% versus 26%),
- antidepressant use among those with depression (88% versus 86%), or
- participation in physical therapy (31% versus 29%).
- Only 35% of patients with an SUD received substance abuse treatment.