Attitudes Toward Opioids and Risk of Misuse/Abuse in Patients with Chronic Noncancer Pain Receiving Long-term Opioid Therapy

Objectives. To determine the attitudes of patients toward long-term opioid therapy (LtOT) and the potential risk of misuse/abuse in patients with chronic noncancer pain (CNCP). Design. Prospective, descriptive epidemiological study. Setting. Multidisciplinary tertiary care pain center within the Montreal University Health Center. Subjects. Patients who had had at least one visit at least one year prior to the invitation. Methods. We used four questionnaires: demographic questionnaire, the Drug Attitude Inventory Modified (DAI-M), the Opioid Risk Tool (ORT), and the Screening Tool for Addiction Risk (STAR). All questionnaires were administered in their validated French version. Results. Three hundred seventy patients completed questionnaires. The response rate was 79.26%. Of those who responded, 61.62% women and 38.38% men, the mean age was 57 years. The patients had been treated with LtOT for an average of 6.31 years, and the median dose per day in morphine equivalents was 48.21mg. The DAI-M showed that 32.16% had a positive attitude toward opioids, 39.73% had a negative attitude, and 22.16% had a neutral attitude. The ORT questionnaire demonstrated that 86.2% of the patients were at low risk of abuse/misuse, 13.2% were at moderate risk, and only 0.54% were at high risk. The STAR questionnaire showed that 4.2% had a low risk of abuse/misuse. Conclusions. Despite public opinion, patients treated with LtOT for CNCP and followed in a tertiary care pain center are at low risk for opioid misuse/abuse. We need to refine the way of prescribing opioids, should be selective with our patients, and should relive their pain adequately. Vargas-Schaffer and Cogan