While use of opiod derivatives to treat chronic pain is often an effective strategy, a serious limitation is the potential for medication abuse. A recent study of patients receiving opioid (opiate) medications for chronic pain, has confirmed that a number of warning signs may appear in the medication pre-screening process.
Researchers utilized the Pain Medication Questionnaire (PMQ) as a screening tool to accurately identify which patients receiving opioid medication for chronic-pain management would benefit from the drug and which would potentially abuse it.
The study, conducted by Robert J. Gatchel, Ph.D., ABPP at the University of Texas at Arlington was based on the hypothesis that patients scoring high on the PMQ test would demonstrate higher levels of physical impairment and psychosocial distress as compared to low scoring patients prior to treatment.
Gatchel’s findings largely indicate that the hypothesis was correct. Higher PMQ (H-PMQ) scores correlate with higher levels of substance abuse, psychopathology and physical/life functioning problems amongst patients, as confirmed by the study.
Specifically, those scoring within the H-PMQ range are found to be:
• 3.2 times more likely to request an early refill of medication
• 2.6 times more likely to have substance abuse history
• 2.3 times more likely to drop out of the treatment program
Additionally, 51.7% of divorced persons tested fell within the H-PMQ group, as did 51.2% of those receiving disability payments. This suggests that demographic similarities exist across all PMQ groups, making the results easily generalized to the larger population of chronic-pain patients.
A re-evaluation six months after treatment concluded showed that those who completed the program experienced diminishing PMQ scores over time compared to those who dropped out or were unsuccessfully discharged. This represents the second stage in the development of a sound, reliable screening tool for measuring the risk of opioid medication abuse.
The study has widespread implications for policy makers, insurers and pain physicians. Opioid pain-treatment is a standard of care for over 50 million people in the U.S. and accounts for $70 billion annually in healthcare costs and lost productivity. The aim of the study is to promote a more effective use of healthcare dollars and resources.
Source: Blackwell Publishing