Pharmaceutical Opioid Use Patterns and Indicators of Extramedical Use and Harm in Adults With Chronic Noncancer Pain, 2012-2018.

摘要: Importance: Despite concern about harms related to long-term prescribed opioid use among individuals with chronic noncancer pain (CNCP), no study has examined whether the same patients engage in a risky pattern of consistently for long term. Objective: To examine prevalence, incidence, persistence, and cessation range behaviors, indicators extramedical use, harm who are opioids. Design, Setting, Participants: This 5-year prospective cohort communities across Australia included 1514 adults were opioids CNCP. Data collection took place from August 2012 December 2018, data analysis February November 2020. Exposure: Prescription use. Main Outcomes Measures: High-dose (≥200 oral morphine equivalent [OME] mg/d); requesting an increase dose; early prescription renewal; tampering medication; diversion medication others; International Statistical Classification Diseases Related Health Problems, Tenth Revision dependence. Cessation was also assessed. Results: Of participants, 672 (44.39%) men, mean (SD) age 58 (19) years, 737 (48.68%) unemployed. At each annual interview, approximately 1 8 people (10.98% [95% CI, 10.33%-11.63%] 14.73% 13.98%-15.48%] at any given interview) taking more than 200 OME mg/d; comparatively had requested increased dosage previous 3 months (8.46% 7.89%-9.03%] 23.77% 22.82%-24.73%]); fewer asked renewal (4.61% 4.19%-5.03%] 13.97% 13.24%-14.70%]). In between 3.06% (95% 2.72%-3.40%) 7.86% 7.31%-8.41%) respondents reported 0.47% 0.33%-0.60%) 1.39% 1.16%-1.62%) others. Between 8.28% 7.71%-8.84%) 13.06% 12.35%-13.77%) met criteria dependence interview. Opioid interviews, year (9.15% 8.55%-9.74%]) 5 (20.02% [19.14%-20.89%]). There considerable incidence all behaviors interview next: most engaged these only did so For pharmaceutical dependence, 55.26% 53.81%-56.71%) 64.44% 62.87%-66.00%) cases not meet following interview. Conclusions Relevance: These findings suggest fluidity reinforces need reassessment effectiveness safety over time.