Chronic Pain Prevalent Among Patients with Opioid Use Disorder

<p><li>Opioid use disorder (OUD) is associated with excess mortality, morbidities, and other adverse health and social conditions.&nbsp;OUD is common among individuals with chronic pain&nbsp;conditions, and chronic pain is common among individuals with OUD.</li>
<li>The relationship between chronic pain and OUD and the time course of the two is complex and other physical and mental health problems often co-occur with them both as well.</li>
<li>The goal of this study was to&nbsp;examine chronic pain among patients with OUD, as well as to&nbsp;examine other substance use disorders, health, mental health, and treatment for health and mental health&nbsp;among patients in medical settings using electronic health records (EHRs).<br> Using an EHR database from 2006-2015, the study assessed 5307 adult patients with OUD in a large healthcare system (University of California, Los Angeles of the former&nbsp;<a href="">CTN Pacific Region Node</a>), separating them into four categories:</li>
<li>No chronic pain (<em>No Pain</em>): &nbsp;35.6%,</li>
<li>OUD prior to pain (<em>OUD First</em>): 9.7%,</li>
<li>OUD and pain at the same time (<em>Same Time</em>): 14.9%, and</li>
<li>Pain condition prior to OUD (<em>Pain First</em>): 39.8%</li>
<p>Results found:</p>
<li>Most patients in treatment for OUD had chronic pain conditions&nbsp;(64.4%), and of those patients, 61.8% had chronic pain before their first OUD diagnosis;</li>
<li><em>OUD First</em>&nbsp;patients<strong>&nbsp;</strong>had higher rates of other SUDs, including:</li>
<li>alcohol (33.4% vs. 25.4% for&nbsp;<em>No Pain</em>, 20.7% for<em>&nbsp;Same Time</em>, and 20.3% for&nbsp;<em>Pain First</em>),</li>
<li>cocaine (19% vs. 13.8%, 9.4%, 7.1%), and</li>
<li>alcohol or drug-induced disorders;</li>
<li><em>OUD First</em>&nbsp;patients<strong>&nbsp;</strong>also had the highest rates of HIV and HCV&nbsp;(4.7% and 28.2%);</li>
<li><em>Pain First</em>&nbsp;patients&nbsp;had the highest rates of mental disorder, heart disease, respiratory disease, sleep disorder, cancer, and diabetes.</li>
<p>Conclusions: This study adds to a rapidly growing knowledge base concerning the intersection of chronic pain and opioid use disorder. The&nbsp;alarmingly high rates of chronic pain conditions occurring before OUD&nbsp;and the&nbsp;associated severe mental health and physical health conditions&nbsp;require better models of assessment and coordinated care plans to address these complex medical conditions. <br>
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Hser Y, et al. Chronic Pain Among Patients with Opioid Use Disorder: Results from Electronic Health Records Data.&nbsp;<em>Journal of Substance Abuse Treatment</em>&nbsp;2017 (in press).