TY - JOUR
T1 - Exploratory study examining associations between prescription opioid dose and delay discounting in patients with chronic pain
AU - Morasco, Benjamin J.
AU - Dobscha, Steven K.
AU - Hyde, Stephanie
AU - Mitchell, Suzanne H.
N1 - Funding Information:
Research reported in this article was supported by grant 034083 from the National Institute on Drug Abuse of the National Institutes of Health. The work was also supported by resources from the VA Health Services Research and Development-funded Center to Improve Veteran Involvement in Care at the VA Portland Health Care System (CIN 13-404). No author reports having any potential conflict of interest with this study. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the Department of Veterans Affairs or the National Institute on Drug Abuse.
Publisher Copyright:
© 2019 Journal of Opioid Management, All Rights Reserved.
PY - 2019/1
Y1 - 2019/1
N2 - 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 - 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.
KW - Chronic pain
KW - Delay discounting
KW - Opioid dose
KW - Prescription opioids
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U2 - 10.5055/jom.2019.0482
DO - 10.5055/jom.2019.0482
M3 - Article
C2 - 30855719
AN - SCOPUS:85062688148
VL - 15
SP - 19
EP - 25
JO - Journal of Opioid Management
JF - Journal of Opioid Management
SN - 1551-7489
IS - 1
ER -