Problematic Prescription Opioid Use in an HIV-Infected Cohort
Year: 2012
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Providers treating chronic pain must attempt to relieve suffering, while minimizing problematic prescription opioid use, including addiction and diversion. Previously described risk factors for problematic use include history of substance use, younger age, male sex, psychiatric comorbidity, and lower education level. METHODS: We examined these risk factors in HIV-infected individuals, using cross-sectional and longitudinal data from the Manhattan HIV Brain Bank. Problematic use was defined as illicit substance use (documented by urine toxicology or structured psychiatric interview), while receiving prescription opioids. RESULTS: Among 173 participants prescribed opioids, 62% had problematic use, the majority of which was discovered by urine toxicology. Problematic use was associated with past substance use, current psychiatric disorder, and poorer adherence to antiretrovirals. However, when participants without problematic use at baseline were followed longitudinally, these factors were not predictive. Furthermore, the cumulative incidence of problematic use behaviors was no greater than in a similar group of participants who were not prescribed opioids. CONCLUSIONS: Problematic prescription opioid use is common among HIV-infected individuals and is associated with history of substance use, current psychiatric disorder, and poor adherence to antiretrovirals. However, these factors do not predict future problematic use in those who are not currently using illicit substances, and the prescription of an opioid does not seem to predispose patients toward a future substance use disorder. Rather than attempting to assess risk for problematic prescription opioid use in HIV-infected individuals, we recommend baseline and follow-up urine toxicology.
Institutions: Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: National NeuroAIDS Tissue Consortium Statistics and Data Coordinating Center, HIV-associated Neuropathy: Ethnic Disparities and Pathogenesis, Mount Sinai Institutes for Clinical and Translational Sciences, G4140207963, G424471100, The Manahattan HIV Brain Bank, The Manhattan HIV Brain Bank, Development of a Behavioral Intervention for Chronic Pain in Individuals with HIV, G6315187019
OpenAlex ID: W2032744545