Independent association of tobacco use with opioid use disorder in patients of European ancestry with chronic non-cancer pain. (1st April 2020)

• Record Type: Journal Article
• Authors: Cheatle, Martin D.; Falcone, Mary; Dhingra, Lara; Lerman, Caryn
• Is Part Of: Drug and alcohol dependence. Volume 209(2020)
• Publication Date: 2020-04-01
• Subjects: Opioids -- Chronic pain -- Opioid use disorder -- Tobacco use; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2020.107901
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Long term opioid therapy (LTOT) for chronic pain can lead to opioid use disorder (OUD). We examined risk factors for OUD in patients with chronic non-cancer pain on LTOT. Tobacco use was significantly associated with OUD (aOR 7.6). Tobacco use may increase the risk of OUD for patients receiving LTOT. Abstract: Background: The harms associated with prescription opioid abuse have become a public health crisis. There is a need for evidence-based objective markers of the risk of opioid use disorder (OUD) in patients with pain receiving opioid treatment. The objective of this study was to evaluate the independent association of tobacco use and OUD in patients with chronic non-cancer pain. Methods: This cross-sectional naturalistic study evaluated 798 adults ≥ 18 years with chronic non-cancer pain treated with long-term opioid therapy (≥ 6 months) who either developed an OUD (cases, n = 216) or displayed no evidence of an OUD (controls, n = 582). The primary outcome was presence of OUD. In addition to current self-reported tobacco use (primary predictor), covariates included demographics, pain severity, and psychiatric history. Data were collected between November 2012 and September 2018. Results: Current tobacco use independently was strongly associated with OUD [odds ratio (OR) 14.0, 95 % confidence interval (CI) 9.5–20.6, p < 0.001], and this association remained significant after adjusting for other risk factors [adjusted odds ratio (aOR) 7.6, 95 % CI 4.8–12.2, p < 0.001]. Other factors associated independently with development of OUD included age, marital status, financial status, education and pain severity. Conclusions and relevance: Current tobacco use is significantly associated with OUD in patients with chronic pain receiving long-term opioid therapy.