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Predictors of long-term opioid use found for patients with lumbar pain
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The results of a recent study indentify nonsurgical treatment and smoking as independent predictors of long-term opioid use among patients with painful lumbar spine conditions.
The study, conducted by Erin E. Krebs, MD, and colleagues, appears in the January issue of The Journal of Pain.
“[Nonsurgical] treatment and smoking independently predicted long-term continued opioid use,” the authors wrote in their abstract. “To our knowledge, this is the first longitudinal study to assess predictors of long-term and incident opioid use among patients with lumbar spine conditions.”
Orthopedics Today Editorial Board member Todd J. Albert, MD, said that the study is important for several reasons. “It reaffirms what many of us have thought; that is, for certain diagnoses, the outcomes of surgery may outweigh the associated risks,” he told OrthoSuperSite.com. “The slippery slope of chronic opioid use is not a path I would choose if there was a viable alternative.”
Using data from the Spine Patient Outcomes Research Trial (SPORT), Krebs and her colleagues studied 2,110 patients with back pain due to lumbar disc herniation or spinal stenosis who were recruited from 13 spine specialty centers in the United States.
At baseline, the investigators discovered that 42% of the patients reported using opioids for their back pain. They also found that 33% of patients took opioids daily for their pain, according to a press release from the American Pain Society.
According to the study abstract, the investigators found that 25% of the patients who reported opioid use at baseline continued using opioids at 12-months and 21% used them at 2-years.
The investigators discovered that nonsurgical treatment and smoking were predictors for long-term opioid use, but they found no significant correlation between long-term opioid use and pain severity.
According to the release, the investigators noted that smoking can be a sign for substance abuse. However, they did not evaluate this characteristic and, therefore, could not consider substance abuse as a predictor for long-term opioid use.
Regarding the finding of nonsurgical treatment as a predictor for long-term use, the investigators noted that the risks linked to continued pain management with opioids in some patients may outweigh the risks of surgery.
- References:
Krebs EE, Lurie JD, Fanciullo, et al. Predictors of long-term opioid use among patients with painful lumbar spine conditions. J Pain. 2010. Jan;11(1): 4-52.