Rate of Addiction in Chronic Pain Patients < 3.27%

Screening for Addiction and Monitoring for Aberrant Behavior in Patients with Chronic Pain | All Things Chronic

A fellow blogger, Painkills2, found and commented on this information:

https://gamamed.org/opioidtraining/Speaker4-presentation.pdf

Prevalence of Addiction in Chronic Pain Patients

  • 24 studies with 2,057 patients with rate of 3.27% for abuse/addiction.
  • Rate of abuse/addiction in patients with no history or current use of substances was 0.19%
  • Fishbain DA. Pain Med. 2008;9:444-58

Aberrant Behavior Prevalence:

  • 17 studies of 2,466 chronic pain patients found rate of 11.5% for aberrant behavior.
  • For patients without SUD, rate was 0.59%.

Risk Factors for aberrant behavior:

  • Lifetime history of substance use disorder (alcohol, tobacco, illicit substances)
  • Psychiatric co-morbidity
  • History of pre-adolescent sexual abuse
  • Family history of substance abuse
  • History of legal problems
  • Younger age (16 – 45)
  • Increased functional impairment

[comment by painkills2] Tobacco, really?  So, if you’re a smoker, no pain meds for you.  And which chronic pain patients don’t also have psychiatric issues?  And if you’ve been sexually abused, no pain meds for you either.  Who’s family doesn’t have substance abuse problems?  And watch out, if you’ve got “legal” problems, no pain meds for you either.  Same goes for those between the ages of 16 and 45, a rather large group.  As for functional impairment, doesn’t the constant and unmanaged pain cause that too?

How to use risk assessment tools

Should not be used to deprive patients of pain management or opioid therapy but to identify those who are at risk for addiction…

[comment by painkills2] once you’re “identified” as at risk for addiction, you now have a label you’ll carry for the rest of your life.

Balancing Benefits/Risks

Patients with addiction less likely to use illicit drugs if painful conditions controlled…

When to Taper Opioids

DO NOT abandon the patient even if you refer…

[comment by painkills2] Gosh, I wish there was a law that said this, because doctors do it all the time, with no consequences whatsoever.

Summary

[comment by painkills2] Considering the low incidence of addiction in the chronic pain patient population, this seems like a lot of effort to catch the small percentage of us that may become addicted to our legally prescribed medications.

15 thoughts on “Rate of Addiction in Chronic Pain Patients < 3.27%

  1. Payne Hertz

    “Risk assessment tools” equals “patient profiling” equals “institutionalized bigotry.”

    “Should not be used to deprive patients of pain management or opioid therapy “

    But we’ll just ignore the fact that this is exactly what “risk stratification” is going to be used for.

    Racial profiling should not be used to deprive minorities of job opportunities, but only to identify segments of the population that may prove to have “aberrant behaviors.”

    Liked by 2 people

    Reply
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    1. Zyp Czyk Post author

      I’m literally shocked. Once again the unexpected prevails, odds be damned!

      The longer I live, the more aware I am that anything can happen anytime… and often does :-)

      Liked by 1 person

      Reply
    2. Payne Hertz

      I’m not surprised. The sadistic sociopath at the VA who bullied and abused me and had me taken off my pain meds cold turkey has also found his way into a (paid) position as a leading “advocate” for pain patients. Trust me you know who he is. It is utterly galling to me to see this barbarian being treated as a hero by the chronic pain community, who apparently can’t see that this fraud’s real agenda isn’t in our interest, so blinded are they by anyone who argues in favor of continued access to pain meds.

      These guys can seem quite civilized when they are reading off the script Big Pharma gives them to read; face-to-face in the office it can be an entirely different matter. While Big Pharma’s agenda may overlap at points with ours—they want to sell us pain meds and many in pain desperately need them—don’t forget that they are one of the primary forces pushing to maintain drug prohibition despite its catastrophic history of failure and abuses. Doctors and Big Pharma have a vested interest in maintaining the status quo because it is extremely profitable for them to do so. While many doctors seem to be advocating for us, few of them are openly challenging prohibition or acknowledging that it is their monopoly over pain meds that leads to us being abused, exploited and denied treatment.

      They advocate for even greater and more invasive “monitoring” for us, while they demand we get government regulators off their case and back onto ours where they steadfastly believe it belongs. They peddle the ludicrous fiction that doctors can somehow keep people from being hurt by these drugs and therefore should be the only ones to control them. They are quite comfortable promoting tools like prescription drug monitoring programs which can stigmatize innocent people for life with an electronic version of the Scarlet Letter, with the “A” being for “addict.” Give them time though, and perhaps they will bring back the brand.

      Liked by 2 people

      Reply
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