PMID- 30562677
OWN - NLM
STAT- MEDLINE
DCOM- 20190625
LR  - 20190625
IS  - 1879-0046 (Electronic)
IS  - 0376-8716 (Linking)
VI  - 195
DP  - 2019 Feb 1
TI  - Withdrawal symptoms predict prescription opioid dependence in chronic pain 
      patients.
PG  - 27-32
LID - S0376-8716(18)30821-4 [pii]
LID - 10.1016/j.drugalcdep.2018.11.013 [doi]
AB  - BACKGROUND: The last version of the Diagnostic and Statistical Manual of Mental 
      Disorders (DSM-5) includes substantial changes for prescription opioid-use 
      disorder (POUD). After its removal as a criterion, the goal of this study was to 
      estimate the prevalence of withdrawal symptoms in long-term users of prescription 
      opioids and its association with the new DSM-5 POUD classification. METHODS: Data 
      were collected from 215 long-term consumers of opioid medication who were chronic 
      non-cancer pain patients. Participants completed sociodemographic, Adjective 
      Rating Scale for Withdrawal (ARSW), opioid treatment characteristics, POUD 
      criteria (DSM-5), and pain intensity measurements. RESULTS: 26.6% of the 
      participants were classified with moderate to severe POUD. Higher intensity of 
      withdrawal symptoms was found in patients with moderate/severe POUD, younger age, 
      and higher pain intensity (p < .01). Anxiolytics (p < .01) and antidepressants 
      use (p < .05) and percentage of smokers (p < .05) were significantly higher in 
      patients with severe withdrawal. Logistic regression analyses suggested moderate 
      [odds ratio (OR) = 3.25] and severe (OR = 10.52) withdrawal as the strongest 
      predictor of POUD. Age, anxiolytics use, and smoking were also associated with 
      POUD, but multilevel analysis showed that these variables do not moderate the 
      association between withdrawal intensity and POUD. CONCLUSION: Escalation of 
      withdrawal intensity during opioid treatment can be used to identify patients 
      with POUD. Further studies are needed to assess the clinical implications of 
      these findings during long-term opioid therapy for chronic pain.
CI  - Copyright (c) 2018 Elsevier B.V. All rights reserved.
FAU - Coloma-Carmona, Ainhoa
AU  - Coloma-Carmona A
AD  - Center for Applied Psychology, Miguel Hernandez University, Avenida Universidad, 
      s/n, 03202, Elche, Spain. Electronic address: ainhoa.coloma@umh.es.
FAU - Carballo, Jose L
AU  - Carballo JL
AD  - Center for Applied Psychology, Miguel Hernandez University, Avenida Universidad, 
      s/n, 03202, Elche, Spain. Electronic address: jcarballo@umh.es.
FAU - Rodriguez-Marin, Jesus
AU  - Rodriguez-Marin J
AD  - Center for Applied Psychology, Miguel Hernandez University, Avenida Universidad, 
      s/n, 03202, Elche, Spain. Electronic address: rod.marin@umh.es.
FAU - Perez-Carbonell, Ana
AU  - Perez-Carbonell A
AD  - University General Hospital of Elche, Camino de la Almazara, 11, 03203, Elche, 
      Spain. Electronic address: perez_anacar@gva.es.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20181203
PL  - Ireland
TA  - Drug Alcohol Depend
JT  - Drug and alcohol dependence
JID - 7513587
RN  - 0 (Analgesics, Opioid)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Analgesics, Opioid/*adverse effects/therapeutic use
MH  - Chronic Pain/diagnosis/*drug therapy/*epidemiology
MH  - Drug Prescriptions
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Opioid-Related Disorders/diagnosis/*epidemiology
MH  - Pain Measurement/drug effects/*methods
MH  - Predictive Value of Tests
MH  - Substance Withdrawal Syndrome/diagnosis/*epidemiology
MH  - Substance-Related Disorders/diagnosis/epidemiology
OTO - NOTNLM
OT  - Chronic pain
OT  - DSM-5
OT  - Opioid withdrawal
OT  - Prescription opioids
EDAT- 2018/12/19 06:00
MHDA- 2019/06/27 06:00
CRDT- 2018/12/19 06:00
PHST- 2018/10/24 00:00 [received]
PHST- 2018/11/12 00:00 [accepted]
PHST- 2018/12/19 06:00 [pubmed]
PHST- 2019/06/27 06:00 [medline]
PHST- 2018/12/19 06:00 [entrez]
AID - S0376-8716(18)30821-4 [pii]
AID - 10.1016/j.drugalcdep.2018.11.013 [doi]
PST - ppublish
SO  - Drug Alcohol Depend. 2019 Feb 1;195:27-32. doi: 10.1016/j.drugalcdep.2018.11.013. 
      Epub 2018 Dec 3.