Risk and Risk Factors for Chronic Opioid Use Among Opioid-Naive Patients With Newly Diagnosed Musculoskeletal Pain in the Neck, Shoulder, Knee, or Low Back

Letters2 April 2019Risk and Risk Factors for Chronic Opioid Use Among Opioid-Naive Patients With Newly Diagnosed Musculoskeletal Pain in the Neck, Shoulder, Knee, or Low BackJasmin Moshfegh, MA, MSc, Steven Z. George, PT, PhD, and Eric Sun, MD, PhDJasmin Moshfegh, MA, MScStanford University School of Medicine, Stanford University, Stanford, California (J.M., E.S.)Search for more papers by this author, Steven Z. George, PT, PhDDuke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina (S.Z.G.)Search for more papers by this author, and Eric Sun, MD, PhDStanford University School of Medicine, Stanford University, Stanford, California (J.M., E.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-2261 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Musculoskeletal pain is a common condition, and patients who have it may transition to chronic opioid use. However, the risk and risk factors for chronic opioid use among patients with new musculoskeletal pain are not fully understood.Objective: To characterize the risk and risk factors for chronic opioid use among opioid-naive patients with newly diagnosed musculoskeletal pain in the knee, neck, low back, or shoulder.Methods and Findings: The IBM MarketScan database provides data on health care use by patients receiving private insurance through a participating employer or government organization. Compared with the general U.S. population, the MarketScan population ...References1. Aizcorbe A, Liebman E, Pack S, Cutler DM, Chernew ME, Rosen AB. Measuring health care costs of individuals with employer-sponsored health insurance in the U.S.: a comparison of survey and claims data. Stat J IAOS. 2012;28:43-51. [PMID: 26146526] doi:10.3233/SJI-2012-0743 CrossrefMedlineGoogle Scholar2. Von Korff M, Wagner EH, Dworkin SF, Saunders KW. Chronic pain and use of ambulatory health care. Psychosom Med. 1991;53:61-79. [PMID: 2011651] CrossrefMedlineGoogle Scholar3. van Walraven C, Austin PC, Jennings A, Quan H, Forster AJ. A modification of the Elixhauser comorbidity measures into a point system for hospital death using administrative data. Med Care. 2009;47:626-33. [PMID: 19433995] doi:10.1097/MLR.0b013e31819432e5 CrossrefMedlineGoogle Scholar4. Sun EC, Darnall BD, Baker LC, Mackey S. Incidence of and risk factors for chronic opioid use among opioid-naive patients in the postoperative period. JAMA Intern Med. 2016;176:1286-93. [PMID: 27400458] doi:10.1001/jamainternmed.2016.3298 CrossrefMedlineGoogle Scholar5. Phillips JK, Ford MA, Bonnie RJ, eds. Trends in opioid use, harms, and treatment. In: Phillips JK, Ford MA, Bonnie RJ, eds. Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use. Washington, DC: National Academies Pr; 2017:187-266. Google Scholar Author, Article, and Disclosure InformationAffiliations: Stanford University School of Medicine, Stanford University, Stanford, California (J.M., E.S.)Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina (S.Z.G.)Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.Financial Support: By grant K08DA042314 from the National Institute on Drug Abuse (Dr. Sun) and grant UG3AT009790 from the National Center for Complementary and Integrative Health (Dr. George). Data for this project were accessed using the Stanford Center for Population Health Sciences Data Core, which is supported by a National Institutes of Health National Center for Advancing Translational Sciences Clinical and Translational Science Award (UL1 TR001085) and by internal Stanford funding.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-2261.Reproducible Research Statement: Study protocol and statistical code: Available from the authors on request (e-mail, [email protected]edu). Data set: As an alternative to providing a deidentified data set in the public domain, we currently allow access for the purpose of reanalyses or appropriate follow-up analyses by any qualified investigator willing to sign a contract with the host institution limiting use of data without direct identifiers of personally identifiable information or protected health information, in accordance with regulations from the Health Insurance Portability and Accountability Act of 1996, and with a 15-day manuscript review for compliance purposes. For access to the data, interested parties can contact Dr. Mark Cullen (e-mail, [email protected]edu).This article was published at Annals.org on 18 December 2018. 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