Traits Associated with Drug Disorders

Photo: Two hands handcuffed

Time spent in jail was one of the
largest predictors of prescription
drug use disorder; © SXC

The study found that by identifying characteristics of prescription drug abuse, primary care clinicians can identify those at risk and provide appropriate treatment.

Researchers conducted a study to examine the clinical characteristics of individuals with lifetime prescription drug use disorder (PDUD), among a population of primary care patients with chronic pain. They compared those afflicted with PDUD to individuals with other substance use disorders (SUD) as well as those without any history of SUD. Participants recruited for the study experienced chronic pain for more than three months, reported use of prescription or non-prescription pain medications.

Of the nearly 600 participants studied, researchers found that 18 percent had lifetime PDUD of which in this subgroup 90 percent had an additional substance addiction. More than 24 percent had an SUD other than PDUD, and 57 percent had no lifetime history of any substance problem. Of note however, only 60 were female, and 60 percent were of African decent and likely to be unemployed and poor.

The study identified a number of factors associated with prescription drug use disorder, including jail time, severely disabling pain, cigarette smoking, family history of substance abuse, white, male and post-traumatic stress disorder. Except for race, the same factors also predicted having other substance use disorders compared to those without any substance problem. Insurance, employment, income, education and age were not associated with substance use disorders of any type in this sample.

"This data strongly suggests that physicians treating patients with pain should assess for SUD prior to prescribing opioid analgesics," lead author Jane M. Liebschutz said. "This research may help direct care, including treatment for pain substance use disorders, as primary care physicians may not be as aware of the overlap between pain and addictions. In particular, physicians may not think of assessing for time spent in jail, which was the largest predictor of having PDUD," said Liebschutz.; Source: Boston University Medical Center