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Emergency Department Patient Perspectives on the Risk of Addiction to Prescription Opioids. Pain Med 2016 Jan;17(1):114-21

Date

09/04/2015

Pubmed ID

26332701

DOI

10.1111/pme.12862

Scopus ID

2-s2.0-84940920757   12 Citations

Abstract

OBJECTIVE: To characterize emergency department (ED) patients' knowledge and beliefs about the addictive potential of opioids.

DESIGN: Mixed methods analysis of data from a randomized controlled trial.

SETTING: Urban academic ED (>88,000 visits).

SUBJECTS: One hundred and seventy four discharged ED patients prescribed hydrocodone-acetaminophen for acute pain.

METHODS: The study analyzed data collected from a randomized controlled trial investigating patients' knowledge of opioids. ED patients discharged with hydrocodone-acetaminophen completed an audio-recorded phone interview 4–7 days later. This analysis focuses on responses about addiction. Responses were categorized using content analysis; thematic analysis identified broad themes common across different categories.

RESULTS: Participants' mean age was 45.5 years (SD, 14.8), 58.6% female, 50.6% white, and the majority had an orthopedic diagnosis (24.1% back pain, 52.3% other injuries). Responses were categorized first based on whether the patient believed that opioids could be addictive (categorized as: yes, 58.7%; no, 19.5%; depends, 17.2%; or do not know, 4.6%), and second based on whether or not the patient discussed his/her own experience with the medication (categorized as: personalized, 35.6%; or not personalized, 64.4%). Cohen's Kappa was 0.84 for all categories. Three themes emerged in the thematic analysis: theme 1) patients expect to “feel” addicted if they are addicted, theme 2) patients fear addiction, and theme 3) side effects affected patient views of addiction.

CONCLUSION: In this sample, patients had misconceptions about opioid addiction. Some patients did not know opioids could be addictive, others underestimated their personal risk of addiction, and others overtly feared addiction and, therefore, risked inadequate pain management. Despite limited data, we recommend providers discuss opioid addiction with their patients.

Author List

Conrardy M, Lank P, Cameron KA, McConnell R, Chevrier A, Sears J, Ahlstrom E, Wolf MS, Courtney DM, McCarthy DM

Author

Michael Conrardy MD Assistant Professor in the Emergency Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Acetaminophen
Acute Pain
Adult
Aged
Analgesics, Opioid
Back Pain
Behavior, Addictive
Drug Combinations
Emergency Service, Hospital
Female
Humans
Hydrocodone
Male
Middle Aged
Pain Measurement
Prescriptions
Risk