Patient-reported factors associated with degree of pain medication dependence and presence of severe dependence among spinal outpatients.

Abstract

Aim: To identify risk factors for pain medication dependence. Materials & methods: Chronic spinal pain outpatients (n=106) completed the Leeds DependenceQuestionnaire (LDQ) and measures of potential risk factors. Participants with high (n=3) and low (n=3) dependence were interviewed. Results: Mean LDQ score was 11.52 (standard deviation 7.35) and 15/106 participants (14.2%) were severely dependent (LDQ ≥20). In linear regression, pain intensity (β=0.313, p<0.001), being disabled by pain (β=0.355, p<0.001), borrowing pain medication (β=0.209, p=0.006), and emergency phone calls or clinic visits (β=0.169, p=0.029) were associated with degree of dependence across the range of LDQ scores. In logistic regression, pain intensity (p=0.001) and borrowing pain medication (p=0.004) increased the odds of severe dependence. Interviewees described how their pain influenced their pain medication use and one described pain medication addiction. Conclusion: Interventions to reduce pain intensity and pain-related disability may reduce pain medication dependence.