TY - JOUR
T1 - Pain, Substance Use Disorders and Opioid Analgesic Prescription Patterns in Veterans with Hepatitis C
AU - Whitehead, Ashlee J.
AU - Dobscha, Steven K.
AU - Morasco, Benjamin J.
AU - Ruimy, Samantha
AU - Bussell, Cara
AU - Hauser, Peter
PY - 2008/7
Y1 - 2008/7
N2 - To examine the prevalence of pain, substance use disorder (SUD) diagnoses, and opioid analgesic prescription patterns among veterans infected with the hepatitis C virus (HCV), a retrospective review of the medical records of 8,224 HCV-positive (HCV+) veterans was performed. Twenty-nine percent and 46% of HCV+ patients were prescribed opioids in the prior one and three years, respectively. Sixty-seven percent of HCV+ patients had documented pain diagnoses and 56% had SUD diagnoses. Patients with co-occurring pain and SUD were less likely to be prescribed opioids than patients with pain only (prior year: 36% vs. 43%, P < 0.001; three years: 56% vs. 60%, P < 0.01). There were no differences in numbers of early opioid prescription fills or numbers of opioid prescribers when comparing patients with co-occurring pain and SUD to patients with pain only. Veterans with co-occurring pain and opioid use disorder had fewer early opioid fills than veterans with pain only (prior year: 2.6 vs. 5.3 days, P < 0.01; three years: 6.1 vs. 13.4 days, P < 0.001). These data demonstrate that pain and SUD diagnoses were common among HCV+ patients, and that opioids were frequently prescribed. Co-occurring SUD was not associated with indicators of prescription opioid misuse.
AB - To examine the prevalence of pain, substance use disorder (SUD) diagnoses, and opioid analgesic prescription patterns among veterans infected with the hepatitis C virus (HCV), a retrospective review of the medical records of 8,224 HCV-positive (HCV+) veterans was performed. Twenty-nine percent and 46% of HCV+ patients were prescribed opioids in the prior one and three years, respectively. Sixty-seven percent of HCV+ patients had documented pain diagnoses and 56% had SUD diagnoses. Patients with co-occurring pain and SUD were less likely to be prescribed opioids than patients with pain only (prior year: 36% vs. 43%, P < 0.001; three years: 56% vs. 60%, P < 0.01). There were no differences in numbers of early opioid prescription fills or numbers of opioid prescribers when comparing patients with co-occurring pain and SUD to patients with pain only. Veterans with co-occurring pain and opioid use disorder had fewer early opioid fills than veterans with pain only (prior year: 2.6 vs. 5.3 days, P < 0.01; three years: 6.1 vs. 13.4 days, P < 0.001). These data demonstrate that pain and SUD diagnoses were common among HCV+ patients, and that opioids were frequently prescribed. Co-occurring SUD was not associated with indicators of prescription opioid misuse.
KW - Opioids
KW - hepatitis C
KW - medication misuse
KW - pain management
KW - veterans
UR - http://www.scopus.com/inward/record.url?scp=45849101744&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=45849101744&partnerID=8YFLogxK
U2 - 10.1016/j.jpainsymman.2007.08.013
DO - 10.1016/j.jpainsymman.2007.08.013
M3 - Article
C2 - 18358690
AN - SCOPUS:45849101744
SN - 0885-3924
VL - 36
SP - 39
EP - 45
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
IS - 1
ER -