TY - JOUR
KW - Adaptation, Psychological
KW - Analgesics, Opioid/adverse effects/therapeutic use
KW - Behavior, Addictive/psychology
KW - Chronic Disease
KW - Colorado
KW - Female
KW - Focus Groups
KW - Humans
KW - Male
KW - Opioid-Related Disorders/prevention & control
KW - Pain/drug therapy/psychology
KW - Patient Compliance/psychology
KW - Psychological Tests
KW - Sex Factors
KW - Stress, Psychological/etiology
AU - K. L. Kirsh
AU - C. Jass
AU - D. S. Bennett
AU - J. E. Hagen
AU - S. D. Passik
A1 - 
AB - OBJECTIVE: Completely compliant drug-taking behavior is associated with opioid therapy that is usually highly beneficial to the pain patient, whereas frequent and severe aberrant behavior is generally associated with therapy that is potentially harmful to the patient and borders on addiction. There is a large group of patients in the middle between these two extremes: those who display aberrant behaviors periodically, who may additionally have a mixed response to opioid therapy, the overall results of which are less than satisfying (often in the domain of functionality) to the clinician. We have used the term chemical coping to describe this vast middle ground and seek to begin a line of research starting with the development of a clinically useful tool to identify this subset of patients. METHODS: A background review is provided to highlight the need for better understanding of chemical coping. In addition, the first steps in creating a chemical coping tool are discussed, including the results of focus group interviews to determine the clarity, understandability of the items, and to assure that they are not objectionable or offensive. A total of 15 patients and 15 professionals completed this phase of the project. RESULTS: Both the professionals and patients reported that the items were generally clear and understandable. In addition, although the items cover potentially sensitive topics and some were designed with a provocative edge, the respondents had few requested changes. The researchers are moving forward with the next phase of research. SIGNIFICANCE OF RESULTS: The middle ground between compliant medication use and addiction, which we call chemical coping, is poorly understood and woefully underresearched. Despite this gap in our knowledge base, it is an often observed phenomenon. Creating a tool to identify these characteristics can lead to better treatment outcomes and earlier interventions to help improve compliance with medication regimens.
BT - Palliative & supportive care
C5 - Opioids & Substance Use
CP - 3
CY - England
IS - 3
JF - Palliative & supportive care
N2 - OBJECTIVE: Completely compliant drug-taking behavior is associated with opioid therapy that is usually highly beneficial to the pain patient, whereas frequent and severe aberrant behavior is generally associated with therapy that is potentially harmful to the patient and borders on addiction. There is a large group of patients in the middle between these two extremes: those who display aberrant behaviors periodically, who may additionally have a mixed response to opioid therapy, the overall results of which are less than satisfying (often in the domain of functionality) to the clinician. We have used the term chemical coping to describe this vast middle ground and seek to begin a line of research starting with the development of a clinically useful tool to identify this subset of patients. METHODS: A background review is provided to highlight the need for better understanding of chemical coping. In addition, the first steps in creating a chemical coping tool are discussed, including the results of focus group interviews to determine the clarity, understandability of the items, and to assure that they are not objectionable or offensive. A total of 15 patients and 15 professionals completed this phase of the project. RESULTS: Both the professionals and patients reported that the items were generally clear and understandable. In addition, although the items cover potentially sensitive topics and some were designed with a provocative edge, the respondents had few requested changes. The researchers are moving forward with the next phase of research. SIGNIFICANCE OF RESULTS: The middle ground between compliant medication use and addiction, which we call chemical coping, is poorly understood and woefully underresearched. Despite this gap in our knowledge base, it is an often observed phenomenon. Creating a tool to identify these characteristics can lead to better treatment outcomes and earlier interventions to help improve compliance with medication regimens.
PP - England
PY - 2007
SN - 1478-9515; 1478-9515
SP - 219
EP - 226
EP - 
T1 - Initial development of a survey tool to detect issues of chemical coping in chronic pain patients
T2 - Palliative & supportive care
TI - Initial development of a survey tool to detect issues of chemical coping in chronic pain patients
U1 - Opioids & Substance Use
U2 - 17969825
VL - 5
VO - 1478-9515; 1478-9515
Y1 - 2007
ER -