Impulsivity and risk for prescription opioid misuse in a chronic pain patient sample

Abstract Misuse of, and addiction to, prescription opioid pain relievers is a growing concern, in both non-clinical samples and chronic pain patients receiving opioid analgesic therapy. Research is needed to identify which patients may be more prone to misuse or dependence on opioids in a chronic pa...

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Bibliographic Details
Published in:Addictive behaviors 2016-09, Vol.60, p.184-190
Main Authors: Vest, Noel, Reynolds, Caleb J, Tragesser, Sarah L
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Analgesics
Chronic Pain - drug therapy
Chronic Pain - psychology
Correlation analysis
Drug use
Female
Humans
Impulsive Behavior
Impulsivity
Male
Middle Aged
Opioid Use Disorder
Opioid-Related Disorders - epidemiology
Opioid-Related Disorders - psychology
Pain management
Prescription Drug Misuse - psychology
Prescription Drug Misuse - statistics & numerical data
Psychiatry
Risk assessment
Risk Factors
Risk for opioid misuse
Sensation Seeking
Surveys and Questionnaires
Urgency
Young Adult
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Summary:Abstract Misuse of, and addiction to, prescription opioid pain relievers is a growing concern, in both non-clinical samples and chronic pain patients receiving opioid analgesic therapy. Research is needed to identify which patients may be more prone to misuse or dependence on opioids in a chronic pain treatment setting. Based on literature showing the role of impulsivity in substance use disorders generally, we predicted that impulsivity may also be important to understanding which individuals may be at risk for opioid misuse when opioids are prescribed for pain. The present study examined associations between impulsivity facets and measures of prescription opioid misuse and symptoms. Four facets of impulsivity were examined: Urgency, Sensation Seeking, lack of Premeditation, and lack of Perseverance. 143 patients receiving treatment for chronic pain at a regional pain clinic completed a series of questionnaires including the UPPS and measures of opioid risk and misuse. Consistent with predictions, Urgency was associated with risk for future misuse (β = 0.246, p < 0.05), current misuse (β = 0.253, p < 0.01), and symptoms of current Opioid Use Disorder (OUD; β = 0.206, p < 0.05). Sensation Seeking was also associated with current misuse (β = 0.279, p < 0.01). These results suggest that identifying facets of impulsivity is important to understanding and assessing for risk of prescription opioid misuse in the context of chronic pain treatment. These data indicate that patients who react impulsively to negative mood states and cravings may be especially prone to developing aberrant use patterns when taking prescription opioids. This is the first known study to identify the role of Urgency in predicting risk for OUDs in chronic pain patients.
ISSN:0306-4603
1873-6327
DOI:10.1016/j.addbeh.2016.04.015