Exploratory study examining associations between prescription opioid dose and delay discounting in patients with chronic pain

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Although some research has identified correlates of high-dose opioid prescriptions, relatively little is known about factors that lead to higher doses. Delay discounting (DD), defined as the subjective value of a reward declining as a function of the delay to that reward, is an objective measure of impulsivity. DD is commonly studied in the context of addictive behaviors, and findings consistently demonstrate greater DD among individuals with opioid use disorders. The authors conducted a preliminary investigation to examine the extent to which DD is associated with prescription opioid dose among patients with musculoskeletal pain. DESIGN: Cross-sectional study. SETTING: A single veterans affairs medical center located in the Pacific Northwest. SUBJECTS: Participants with chronic musculoskeletal pain. The authors identified patients prescribed with high doses of opioids (100 mg morphine equivalent per day [MED] or more; n = 17), traditional doses of opioids (5-99 mg MED; n = 34), and patients with pain who were not prescribed opioids (n = 24). METHODS: All participants completed a battery of self-report measures assessing demographic characteristics, pain-related variables, and psychiatric symptoms. Participants also completed a computerized DD task. RESULTS: DD was negatively correlated with average daily opioid dose (p = 0.003) and positively correlated with anxiety (p = 0.013). In a multivariable regression analysis, after controlling for the effects of demographic and clinical factors, DD was significantly associated with prescription opioid dose. CONCLUSIONS: Contrary to study expectations, higher opioid dose was associated with less DD. These findings call for prospective research to further elucidate the relationships between DD and other measures of impulsivity and prescription opioid doses.

Original languageEnglish (US)
Pages (from-to)19-25
Number of pages7
JournalJournal of opioid management
Volume15
Issue number1
DOIs
StatePublished - Jan 1 2019

Fingerprint

Chronic Pain
Opioid Analgesics
Prescriptions
Musculoskeletal Pain
Impulsive Behavior
Reward
Morphine
Demography
Delay Discounting
Northwestern United States
Addictive Behavior
Pain
Veterans
Research
Self Report
Psychiatry
Anxiety
Cross-Sectional Studies
Regression Analysis

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Anesthesiology and Pain Medicine

Cite this

@article{0847f43c7b4f40fa9c1861c19fe34202,
title = "Exploratory study examining associations between prescription opioid dose and delay discounting in patients with chronic pain",
abstract = "OBJECTIVE: Although some research has identified correlates of high-dose opioid prescriptions, relatively little is known about factors that lead to higher doses. Delay discounting (DD), defined as the subjective value of a reward declining as a function of the delay to that reward, is an objective measure of impulsivity. DD is commonly studied in the context of addictive behaviors, and findings consistently demonstrate greater DD among individuals with opioid use disorders. The authors conducted a preliminary investigation to examine the extent to which DD is associated with prescription opioid dose among patients with musculoskeletal pain. DESIGN: Cross-sectional study. SETTING: A single veterans affairs medical center located in the Pacific Northwest. SUBJECTS: Participants with chronic musculoskeletal pain. The authors identified patients prescribed with high doses of opioids (100 mg morphine equivalent per day [MED] or more; n = 17), traditional doses of opioids (5-99 mg MED; n = 34), and patients with pain who were not prescribed opioids (n = 24). METHODS: All participants completed a battery of self-report measures assessing demographic characteristics, pain-related variables, and psychiatric symptoms. Participants also completed a computerized DD task. RESULTS: DD was negatively correlated with average daily opioid dose (p = 0.003) and positively correlated with anxiety (p = 0.013). In a multivariable regression analysis, after controlling for the effects of demographic and clinical factors, DD was significantly associated with prescription opioid dose. CONCLUSIONS: Contrary to study expectations, higher opioid dose was associated with less DD. These findings call for prospective research to further elucidate the relationships between DD and other measures of impulsivity and prescription opioid doses.",
author = "Benjamin Morasco and Steven Dobscha and Stephanie Hyde and Suzanne Mitchell",
year = "2019",
month = "1",
day = "1",
doi = "10.5055/jom.2019.0482",
language = "English (US)",
volume = "15",
pages = "19--25",
journal = "Journal of Opioid Management",
issn = "1551-7489",
publisher = "Weston Medical Publishing",
number = "1",

}

TY - JOUR

T1 - Exploratory study examining associations between prescription opioid dose and delay discounting in patients with chronic pain

AU - Morasco, Benjamin

AU - Dobscha, Steven

AU - Hyde, Stephanie

AU - Mitchell, Suzanne

PY - 2019/1/1

Y1 - 2019/1/1

N2 - OBJECTIVE: Although some research has identified correlates of high-dose opioid prescriptions, relatively little is known about factors that lead to higher doses. Delay discounting (DD), defined as the subjective value of a reward declining as a function of the delay to that reward, is an objective measure of impulsivity. DD is commonly studied in the context of addictive behaviors, and findings consistently demonstrate greater DD among individuals with opioid use disorders. The authors conducted a preliminary investigation to examine the extent to which DD is associated with prescription opioid dose among patients with musculoskeletal pain. DESIGN: Cross-sectional study. SETTING: A single veterans affairs medical center located in the Pacific Northwest. SUBJECTS: Participants with chronic musculoskeletal pain. The authors identified patients prescribed with high doses of opioids (100 mg morphine equivalent per day [MED] or more; n = 17), traditional doses of opioids (5-99 mg MED; n = 34), and patients with pain who were not prescribed opioids (n = 24). METHODS: All participants completed a battery of self-report measures assessing demographic characteristics, pain-related variables, and psychiatric symptoms. Participants also completed a computerized DD task. RESULTS: DD was negatively correlated with average daily opioid dose (p = 0.003) and positively correlated with anxiety (p = 0.013). In a multivariable regression analysis, after controlling for the effects of demographic and clinical factors, DD was significantly associated with prescription opioid dose. CONCLUSIONS: Contrary to study expectations, higher opioid dose was associated with less DD. These findings call for prospective research to further elucidate the relationships between DD and other measures of impulsivity and prescription opioid doses.

AB - OBJECTIVE: Although some research has identified correlates of high-dose opioid prescriptions, relatively little is known about factors that lead to higher doses. Delay discounting (DD), defined as the subjective value of a reward declining as a function of the delay to that reward, is an objective measure of impulsivity. DD is commonly studied in the context of addictive behaviors, and findings consistently demonstrate greater DD among individuals with opioid use disorders. The authors conducted a preliminary investigation to examine the extent to which DD is associated with prescription opioid dose among patients with musculoskeletal pain. DESIGN: Cross-sectional study. SETTING: A single veterans affairs medical center located in the Pacific Northwest. SUBJECTS: Participants with chronic musculoskeletal pain. The authors identified patients prescribed with high doses of opioids (100 mg morphine equivalent per day [MED] or more; n = 17), traditional doses of opioids (5-99 mg MED; n = 34), and patients with pain who were not prescribed opioids (n = 24). METHODS: All participants completed a battery of self-report measures assessing demographic characteristics, pain-related variables, and psychiatric symptoms. Participants also completed a computerized DD task. RESULTS: DD was negatively correlated with average daily opioid dose (p = 0.003) and positively correlated with anxiety (p = 0.013). In a multivariable regression analysis, after controlling for the effects of demographic and clinical factors, DD was significantly associated with prescription opioid dose. CONCLUSIONS: Contrary to study expectations, higher opioid dose was associated with less DD. These findings call for prospective research to further elucidate the relationships between DD and other measures of impulsivity and prescription opioid doses.

UR - http://www.scopus.com/inward/record.url?scp=85062688148&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85062688148&partnerID=8YFLogxK

U2 - 10.5055/jom.2019.0482

DO - 10.5055/jom.2019.0482

M3 - Article

VL - 15

SP - 19

EP - 25

JO - Journal of Opioid Management

JF - Journal of Opioid Management

SN - 1551-7489

IS - 1

ER -