• M Gabrielle Pagé, Hichem Saïdi, Mark A Ware, and Manon Choinière.
• *Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM) Departments of †Biomedical Sciences ‡Pharmacology ††Anesthesiology, Faculty of Medicine, Université de Montréal §Alan Edwards Center for Research on Pain, McGill University Departments of ∥Family Medicine #Anesthesiology, Faculty of Medicine, McGill University ¶Alan Edwards Pain Management Unit, McGill University Health Centre, Montréal, QC, Canada.
• Clin J Pain. 2016 Oct 1; 32 (10): 859-69.

ObjectivesThe objectives of this study were to (1) determine the proportion of patients referred to a multidisciplinary pain treatment facility at risk of opioid abuse, (2) examine biopsychosocial factors associated with this risk, and (3) compare patient outcomes 6 months later across risk of opioid abuse and type of treatment (opioids vs. no opioids).MethodsParticipants were 3040 patients (mean age=53.3±14.7 y; female=56%) enrolled in the Quebec Pain Registry between July 2012 and May 2014. Patients answered self-report and nurse-administered questionnaires (pain and psychosocial constructs, Opioid Risk Tool, pain medication, etc.) before initiating treatment at the multidisciplinary pain treatment facility and 6 months later. Data were analyzed using the Pearson χ tests, multivariable binary logistic regression, and multivariate general linear model.ResultsResults showed that 81%, 13%, and 6% of patients were at low, moderate, and severe risk of opioid abuse, respectively. Civil status, pain duration, mental health-related quality of life, and cigarette smoking were significantly associated with risk of opioid abuse (P<0.001). There was a significant interaction between risk of opioid abuse and type of treatment in predicting 6-month pain outcomes and quality of life.DiscussionAlmost 20% of patients had a moderate/severe risk of opioid abuse; whether these patients were taking opioids or not for their pain, they had worse outcomes at follow-up. These results point to the importance of assessing risk of opioid abuse in chronic pain patients and to consider how this risk may impact on their clinical evolution.

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