Addiction Severity Index in a chronic pain sample receiving opioid therapy

Saffier, Kenneth; Colombo, Cynthia; Brown, David; Mundt, Marlon; Fleming, Michael F.

doi:10.1016/j.jsat.2006.12.011

Cited by 46 publications

(32 citation statements)

References 28 publications

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“…49,51–53 In one study of patients with chronic pain, 5.8% reported using alcohol ≥ 10 times in the past 30 days, and 2.4% were intoxicated > 6 times. 54 Saunders et al 52 recently reported concurrent use of opioids and alcohol or sedatives in 12% and 32% of patients with chronic noncancer pain, respectively (Figure 7). Approximately 3% of patients used all 3.…”

Section: Prevalence and Risk Factorsmentioning

confidence: 97%

Risks, Management, and Monitoring of Combination Opioid, Benzodiazepines, and/or Alcohol Use

Gudin

Mogali

Jones

et al. 2013

Postgraduate Medicine

205

122

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The concurrent use of opioids, benzodiazepines (BZDs), and/or alcohol poses a formidable challenge for clinicians who manage chronic pain. While the escalating use of opioid analgesics for the treatment of chronic pain and the concomitant rise in opioid-related abuse and misuse are widely recognized trends, the contribution of combination use of BZDs, alcohol, and/or other sedative agents to opioid-related morbidity and mortality is underappreciated, even when these agents are used appropriately. Patients with chronic pain who use opioid analgesics along with BZDs and/or alcohol are at higher risk for fatal/nonfatal overdose and have more aberrant behaviors. Few practice guidelines for BZD treatment are readily available, especially when they are combined clinically with opioid analgesics and other central nervous system–depressant agents. However, coadministration of these agents produces a defined increase in rates of adverse events, overdose, and death, warranting close monitoring and consideration when treating patients with pain. To improve patient outcomes, ongoing screening for aberrant behavior, monitoring of treatment compliance, documentation of medical necessity, and the adjustment of treatment to clinical changes are essential. In this article, we review the prevalence and pharmacologic consequences of BZDs and/or alcohol use among patients with pain on chronic opioid therapy, as well as the importance of urine drug testing, an indispensable tool for therapeutic drug monitoring, which helps to ensure the continued safety of patients. Regardless of risk or known aberrant drug-related behaviors, patients on chronic opioid therapy should periodically undergo urine drug testing to confirm adherence to the treatment plan.

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Section: Prevalence and Risk Factorsmentioning

confidence: 97%

Risks, Management, and Monitoring of Combination Opioid, Benzodiazepines, and/or Alcohol Use

Gudin

Mogali

Jones

et al. 2013

Postgraduate Medicine

205

122

View full text Add to dashboard Cite

show abstract

“…In primary care settings, prevalence of opioid dependence (using DSM-IV criteria) ranged from 3% to 26% (55,56,59). In pain clinic settings, prevalence of addiction ranged from 2% to 14% (57,58,60,61,(63)(64)(65).…”

Section: Harmsmentioning

confidence: 99%

CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016

Haegerich²,

2016

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“…In addition, alcohol and drug use severity, indicated by ASI composite scores, were higher than those for samples of treated chronic pain and general medical patients, although they were lower than those for addiction treatment samples (Saffier, Columbo, Brown, Mundt, & Fleming, 2007). In the present study, criminal justice and drug use-related outcomes improved at six months post-baseline, and tended to improve even more at the three-year follow-up.…”

Section: Discussionmentioning

confidence: 83%

Criminogenic needs, substance use, and offending among rural stimulant users.

Timko

Booth

Han

et al. 2017

Journal of Rural Mental Health

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There is a need to understand the determinants of both substance use and criminal activity in rural areas in order to design appropriate treatment interventions for these linked problems. The present study drew on a predominant model used to assess and treat offenders -- the Risk-Need-Responsivity (RNR) model -- to examine risk factors for substance use and criminal activity in a rural drug using sample. This study extends the RNR model’s focus on offenders to assessing rural-dwelling individuals using stimulants (N=462). We examined substance use and criminal justice outcomes at 6-month (91%) and 3-year (79%) follow-ups, and used Generalized Estimating Equations to examine the extent to which RNR criminogenic need factors at baseline predicted outcomes at follow-ups. Substance use and criminal justice outcomes improved at six months, and even more at three years, post-baseline. As expected, higher risk was associated with poorer outcomes. Antisocial personality patterns and procriminal attitudes at baseline predicted poorer legal and drug outcomes measured at subsequent follow-ups. In contrast, less connection to antisocial others and fewer work difficulties predicted lower alcohol problem severity, but more frequent alcohol use. Engagement in social-recreational activities was associated with fewer subsequent arrests and less severe alcohol and drug problems. The RNR model’s criminogenic need factors predicted drug use and crime-related outcomes among rural residents. Services adapted to rural settings that target these factors, such as telehealth and other technology-based resources, may hasten improvement on both types of outcomes among drug users.

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Addiction Severity Index in a chronic pain sample receiving opioid therapy

Cited by 46 publications

References 28 publications

Risks, Management, and Monitoring of Combination Opioid, Benzodiazepines, and/or Alcohol Use

Risks, Management, and Monitoring of Combination Opioid, Benzodiazepines, and/or Alcohol Use

CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016

Criminogenic needs, substance use, and offending among rural stimulant users.

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