PMID- 35702830
OWN - NLM
STAT- MEDLINE
DCOM- 20221004
LR  - 20221108
IS  - 1535-7228 (Electronic)
IS  - 0002-953X (Linking)
VI  - 179
IP  - 10
DP  - 2022 Oct
TI  - Diagnosing Prescription Opioid Use Disorder in Patients Using Prescribed Opioids 
      for Chronic Pain.
PG  - 715-725
LID - 10.1176/appi.ajp.21070721 [doi]
AB  - OBJECTIVE: The diagnostic criteria for opioid use disorder, originally developed 
      for heroin, did not anticipate the surge in prescription opioid use and the 
      resulting complexities in diagnosing prescription opioid use disorder (POUD), 
      including differentiation of pain relief (therapeutic intent) from more common 
      drug use motives, such as to get high or to cope with negative affect. The 
      authors examined the validity of the Psychiatric Research Interview for Substance 
      and Mental Disorders, DSM-5 opioid version, an instrument designed to make this 
      differentiation. METHODS: Patients (N=606) from pain clinics and inpatient 
      substance treatment who ever received a >/=30-day opioid prescription for chronic 
      pain were evaluated for DSM-5 POUD (i.e., withdrawal and tolerance were not 
      considered positive if patients used opioids only as prescribed, per DSM-5 
      guidelines) and pain-adjusted POUD (behavioral/subjective criteria were not 
      considered positive if pain relief [therapeutic intent] was the sole motive). 
      Bivariate correlated-outcome regression models indicated associations of 10 
      validators with DSM-5 and pain-adjusted POUD measures, using mean ratios for 
      dimensional measures and odds ratios for binary measures. RESULTS: The 
      prevalences of DSM-5 and pain-adjusted POUD, respectively, were 44.4% and 30.4% 
      at the >/=2-criteria threshold and 29.5% and 25.3% at the >/=4-criteria threshold. 
      Pain adjustment had little effect on prevalence among substance treatment 
      patients but resulted in substantially lower prevalence among pain treatment 
      patients. All validators had significantly stronger associations with 
      pain-adjusted than with DSM-5 dimensional POUD measures (ratios of mean ratios, 
      1.22-2.31). For most validators, pain-adjusted binary POUD had larger odds ratios 
      than DSM-5 measures. CONCLUSIONS: Adapting POUD measures for pain relief 
      (therapeutic intent) improved validity. Studies should investigate the clinical 
      utility of differentiating between therapeutic and nontherapeutic intent in 
      evaluating POUD diagnostic criteria.
FAU - Hasin, Deborah S
AU  - Hasin DS
AD  - Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, 
      Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, 
      Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; 
      Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington 
      Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, 
      Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia 
      University Medical Center, New York (Sonty, Weinberger); Department of 
      Psychiatry, New York University, New York (Ross); Cornell University Medical 
      College, New York (Inturrisi).
FAU - Shmulewitz, Dvora
AU  - Shmulewitz D
AD  - Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, 
      Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, 
      Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; 
      Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington 
      Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, 
      Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia 
      University Medical Center, New York (Sonty, Weinberger); Department of 
      Psychiatry, New York University, New York (Ross); Cornell University Medical 
      College, New York (Inturrisi).
FAU - Stohl, Malka
AU  - Stohl M
AD  - Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, 
      Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, 
      Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; 
      Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington 
      Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, 
      Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia 
      University Medical Center, New York (Sonty, Weinberger); Department of 
      Psychiatry, New York University, New York (Ross); Cornell University Medical 
      College, New York (Inturrisi).
FAU - Greenstein, Eliana
AU  - Greenstein E
AD  - Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, 
      Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, 
      Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; 
      Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington 
      Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, 
      Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia 
      University Medical Center, New York (Sonty, Weinberger); Department of 
      Psychiatry, New York University, New York (Ross); Cornell University Medical 
      College, New York (Inturrisi).
FAU - Aharonovich, Efrat
AU  - Aharonovich E
AD  - Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, 
      Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, 
      Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; 
      Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington 
      Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, 
      Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia 
      University Medical Center, New York (Sonty, Weinberger); Department of 
      Psychiatry, New York University, New York (Ross); Cornell University Medical 
      College, New York (Inturrisi).
FAU - Petronis, Kenneth R
AU  - Petronis KR
AD  - Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, 
      Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, 
      Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; 
      Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington 
      Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, 
      Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia 
      University Medical Center, New York (Sonty, Weinberger); Department of 
      Psychiatry, New York University, New York (Ross); Cornell University Medical 
      College, New York (Inturrisi).
FAU - Von Korff, Michael
AU  - Von Korff M
AD  - Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, 
      Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, 
      Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; 
      Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington 
      Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, 
      Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia 
      University Medical Center, New York (Sonty, Weinberger); Department of 
      Psychiatry, New York University, New York (Ross); Cornell University Medical 
      College, New York (Inturrisi).
FAU - Datta, Samyadev
AU  - Datta S
AD  - Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, 
      Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, 
      Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; 
      Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington 
      Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, 
      Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia 
      University Medical Center, New York (Sonty, Weinberger); Department of 
      Psychiatry, New York University, New York (Ross); Cornell University Medical 
      College, New York (Inturrisi).
FAU - Sonty, Nomita
AU  - Sonty N
AD  - Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, 
      Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, 
      Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; 
      Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington 
      Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, 
      Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia 
      University Medical Center, New York (Sonty, Weinberger); Department of 
      Psychiatry, New York University, New York (Ross); Cornell University Medical 
      College, New York (Inturrisi).
FAU - Ross, Stephen
AU  - Ross S
AD  - Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, 
      Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, 
      Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; 
      Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington 
      Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, 
      Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia 
      University Medical Center, New York (Sonty, Weinberger); Department of 
      Psychiatry, New York University, New York (Ross); Cornell University Medical 
      College, New York (Inturrisi).
FAU - Inturrisi, Charles
AU  - Inturrisi C
AD  - Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, 
      Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, 
      Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; 
      Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington 
      Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, 
      Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia 
      University Medical Center, New York (Sonty, Weinberger); Department of 
      Psychiatry, New York University, New York (Ross); Cornell University Medical 
      College, New York (Inturrisi).
FAU - Weinberger, Michael L
AU  - Weinberger ML
AD  - Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, 
      Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, 
      Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; 
      Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington 
      Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, 
      Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia 
      University Medical Center, New York (Sonty, Weinberger); Department of 
      Psychiatry, New York University, New York (Ross); Cornell University Medical 
      College, New York (Inturrisi).
FAU - Scodes, Jennifer
AU  - Scodes J
AD  - Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, 
      Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, 
      Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; 
      Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington 
      Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, 
      Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia 
      University Medical Center, New York (Sonty, Weinberger); Department of 
      Psychiatry, New York University, New York (Ross); Cornell University Medical 
      College, New York (Inturrisi).
FAU - Wall, Melanie M
AU  - Wall MM
AD  - Department of Psychiatry, Columbia University Medical Center (Hasin, Shmulewitz, 
      Aharonovich, Scodes, Wall) and New York State Psychiatric Institute (Hasin, 
      Shmulewitz, Stohl, Greenstein, Aharonovich, Scodes, Wall), New York; 
      Epidemiology, Pfizer, Inc., New York (Petronis); Kaiser Permanente Washington 
      Health Research Institute, Seattle (Von Korff); Department of Anesthesiology, 
      Rutgers University, Newark, N.J. (Datta); Department of Anesthesiology, Columbia 
      University Medical Center, New York (Sonty, Weinberger); Department of 
      Psychiatry, New York University, New York (Ross); Cornell University Medical 
      College, New York (Inturrisi).
LA  - eng
SI  - ClinicalTrials.gov/NCT02660619
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220615
PL  - United States
TA  - Am J Psychiatry
JT  - The American journal of psychiatry
JID - 0370512
RN  - 0 (Analgesics, Opioid)
RN  - 70D95007SX (Heroin)
SB  - IM
CIN - Am J Psychiatry. 2022 Oct;179(10):696-698. PMID: 36181333
MH  - Analgesics, Opioid/therapeutic use
MH  - *Chronic Pain/diagnosis/drug therapy
MH  - Heroin/therapeutic use
MH  - Humans
MH  - *Opioid-Related Disorders/diagnosis/drug therapy/epidemiology
MH  - Prescriptions
OTO - NOTNLM
OT  - Addiction Psychiatry
OT  - Epidemiology
OT  - Opioids
OT  - Pain
OT  - Substance-Related and Addictive Disorders
EDAT- 2022/06/16 06:00
MHDA- 2022/10/05 06:00
CRDT- 2022/06/15 03:02
PHST- 2022/06/16 06:00 [pubmed]
PHST- 2022/10/05 06:00 [medline]
PHST- 2022/06/15 03:02 [entrez]
AID - 10.1176/appi.ajp.21070721 [doi]
PST - ppublish
SO  - Am J Psychiatry. 2022 Oct;179(10):715-725. doi: 10.1176/appi.ajp.21070721. Epub 
      2022 Jun 15.