TY - JOUR
KW - Adult
KW - Alcohol Drinking/epidemiology
KW - Chronic Pain
KW - Chronic Pain/epidemiology/etiology/therapy
KW - Cross-Sectional Studies
KW - Female
KW - Humans
KW - Male
KW - Massachusetts/epidemiology
KW - Middle Aged
KW - Pain Measurement/methods
KW - Prescription Drug Misuse/statistics & numerical data
KW - Prevalence
KW - primary care
KW - Primary Health Care
KW - Self Medication/methods/statistics & numerical data
KW - Street Drugs
KW - substance use
KW - Substance-Related Disorders/complications/epidemiology
AU - D. P. Alford
AU - J. S. German
AU - J. H. Samet
AU - D. M. Cheng
AU - C. A. Lloyd-Travaglini
AU - R. Saitz
A1 - 
AB - BACKGROUND: Chronic pain is common among patients with drug use disorders. The prevalence of chronic pain and its consequences in primary care patients who use drugs is unknown. OBJECTIVES: To examine: 1) the prevalence of chronic pain and pain-related dysfunction among primary care patients who screen positive for drug use, and 2) the prevalence of substance use to self-medicate chronic pain in this population. DESIGN: This was a cross-sectional analysis. PARTICIPANTS: This study included 589 adult patients who screened positive for any illicit drug use or prescription drug misuse, recruited from an urban, hospital-based primary care practice. MAIN MEASURES: Both pain and pain-related dysfunction were assessed by numeric rating scales, and grouped as: (0) none, (1-3) mild, (4-6) moderate, (7-10) severe. Questions were asked about the use of substances to treat pain. KEY RESULTS: Among 589 participants, chronic pain was reported by 87% (95% CI: 84-90%), with 13% mild, 24% moderate and 50% severe. Pain-related dysfunction was reported by 74% (95% CI: 70-78%), with 15% mild, 23% moderate, and 36% severe. Of the 576 that used illicit drugs (i.e., marijuana, cocaine, and/or heroin), 51% reported using to treat pain (95% CI: 47-55% ). Of the 121 with prescription drug misuse, 81% (95% CI: 74-88%) used to treat pain. Of the 265 participants who reported any heavy drinking in the past 3 months, 38% (95% CI: 32-44%) did so to treat pain compared to 79% (95% CI: 68-90%) of the 57 high-risk alcohol users. CONCLUSIONS: Chronic pain and pain-related dysfunction were the norm for primary care patients who screened positive for drug use, with nearly one-third reporting both severe pain and severe pain-related dysfunction. Many patients using illicit drugs, misusing prescription drugs and using alcohol reported doing so in order to self-medicate their pain. Pain needs to be addressed when patients are counseled about their substance use.
BT - Journal of General Internal Medicine
C5 - Opioids & Substance Use
CP - 5
CY - United States
DO - 10.1007/s11606-016-3586-5
IS - 5
JF - Journal of General Internal Medicine
N2 - BACKGROUND: Chronic pain is common among patients with drug use disorders. The prevalence of chronic pain and its consequences in primary care patients who use drugs is unknown. OBJECTIVES: To examine: 1) the prevalence of chronic pain and pain-related dysfunction among primary care patients who screen positive for drug use, and 2) the prevalence of substance use to self-medicate chronic pain in this population. DESIGN: This was a cross-sectional analysis. PARTICIPANTS: This study included 589 adult patients who screened positive for any illicit drug use or prescription drug misuse, recruited from an urban, hospital-based primary care practice. MAIN MEASURES: Both pain and pain-related dysfunction were assessed by numeric rating scales, and grouped as: (0) none, (1-3) mild, (4-6) moderate, (7-10) severe. Questions were asked about the use of substances to treat pain. KEY RESULTS: Among 589 participants, chronic pain was reported by 87% (95% CI: 84-90%), with 13% mild, 24% moderate and 50% severe. Pain-related dysfunction was reported by 74% (95% CI: 70-78%), with 15% mild, 23% moderate, and 36% severe. Of the 576 that used illicit drugs (i.e., marijuana, cocaine, and/or heroin), 51% reported using to treat pain (95% CI: 47-55% ). Of the 121 with prescription drug misuse, 81% (95% CI: 74-88%) used to treat pain. Of the 265 participants who reported any heavy drinking in the past 3 months, 38% (95% CI: 32-44%) did so to treat pain compared to 79% (95% CI: 68-90%) of the 57 high-risk alcohol users. CONCLUSIONS: Chronic pain and pain-related dysfunction were the norm for primary care patients who screened positive for drug use, with nearly one-third reporting both severe pain and severe pain-related dysfunction. Many patients using illicit drugs, misusing prescription drugs and using alcohol reported doing so in order to self-medicate their pain. Pain needs to be addressed when patients are counseled about their substance use.
PP - United States
PY - 2016
SN - 1525-1497; 0884-8734
SP - 486
EP - 491
EP - 
T1 - Primary Care Patients with Drug Use Report Chronic Pain and Self-Medicate with Alcohol and Other Drugs
T2 - Journal of General Internal Medicine
TI - Primary Care Patients with Drug Use Report Chronic Pain and Self-Medicate with Alcohol and Other Drugs
U1 - Opioids & Substance Use
U2 - 26809204
U3 - 10.1007/s11606-016-3586-5
VL - 31
VO - 1525-1497; 0884-8734
Y1 - 2016
ER -