Medical and psychological predictors of prescription opioids dependence during chronic pain treatment

Abstract

IntroductionDue to the increasing rates of prescription opioids (PO) dependence, there is a need for designing evaluations that detect, before initiating treatment, those patients with a greater probability of developing PO dependence. ObjectiveTo develop a mathematical model for predicting PO dependence in chronic pain patients using medical and psychological variables. MethodParticipants were 210 consumers of PO, of which 47.1% met three or more DSM-IV-TR criteria for psychoactive substance dependence. Socio-demographic, medical and psychological variables were assessed. ResultsThe number of prescribed drugs, years in treatment, PO consumed and specialists visited is significantly higher in opioid-dependent patients, which consume more anxiolytics and have a greater pain intensity and interference. The predictive model created with the variables number of prescribed drugs and opioids consumed, depression, use of anxiolytics and pain intensity correctly classifies 71.5% of opioid-dependent patients. ConclusionsMedical as well as psychological variables seem to be involved in the development of PO dependence, so they both should be considered in the treatment planning. Further studies with a bigger sample size are needed to analyze the applicability of the model to identify PO-dependent patients.