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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
76 to 100 of 304 Research Studies DisplayedSerina PT, Lank PM, Kim HS
Perceptions of signs of addiction among opioid naive patients prescribed opioids in the emergency department.
Patient knowledge deficits related to opioid risks, including lack of knowledge regarding addiction, are well documented. The objective of this study was to characterize patients' perceptions of signs of addiction. The investigators concluded that signs of addiction identified by opioid naive patients were similar to concepts identified in medical definitions. However, participants' understanding also included misconceptions, omissions, and conflated misuse behaviors with signs of addiction.
AHRQ-funded; HS023459.
Citation: Serina PT, Lank PM, Kim HS .
Perceptions of signs of addiction among opioid naive patients prescribed opioids in the emergency department.
J Addict Med 2021 Nov-Dec;15(6):491-97. doi: 10.1097/adm.0000000000000806..
Keywords: Opioids, Substance Abuse, Emergency Department
Sussman AL, Crawford JN, Brakey HR
Use of a benchmark tracking assessment to support expansion of buprenorphine for treatment of opioid use disorder in primary care.
Barriers to the expansion of opioid use disorder (OUD) treatment in primary care using buprenorphine are well documented. Providers require support along a continuum. A systematic tracking framework to enhance provider progress along this continuum is lacking. The investigators developed a benchmark tracking assessment (BTA) as part of data collection in a 5-year study to examine the impact of provider participation in an online intervention to support expansion of buprenorphine treatment for OUD in rural primary care.
AHRQ-funded; HS025345.
Citation: Sussman AL, Crawford JN, Brakey HR .
Use of a benchmark tracking assessment to support expansion of buprenorphine for treatment of opioid use disorder in primary care.
J Am Board Fam Med 2021 Nov-Dec;34(6):1216-20. doi: 10.3122/jabfm.2021.06.210111..
Keywords: Opioids, Primary Care, Medication, Substance Abuse, Behavioral Health
Thompson HM, Sharma B, Bhalla S
Bias and fairness assessment of a natural language processing opioid misuse classifier: detection and mitigation of electronic health record data disadvantages across racial subgroups.
The objective of this study was to assess fairness and bias of a previously validated machine learning opioid misuse classifier. Two experiments were conducted with the classifier's original and external validation datasets from 2 health systems. Bias was assessed via testing for differences in type II error rates across racial/ethnic subgroups (Black, Hispanic/Latinx, White, Other) using bootstrapped 95% confidence intervals. The investigators concluded that standardized, transparent bias assessments were needed to improve trustworthiness in clinical machine learning models.
AHRQ-funded; HS026385.
Citation: Thompson HM, Sharma B, Bhalla S .
Bias and fairness assessment of a natural language processing opioid misuse classifier: detection and mitigation of electronic health record data disadvantages across racial subgroups.
J Am Med Inform Assoc 2021 Oct 12;28(11):2393-403. doi: 10.1093/jamia/ocab148..
Keywords: Opioids, Substance Abuse, Electronic Health Records (EHRs), Health Information Technology (HIT), Racial and Ethnic Minorities
Keenan KE, Rothberg MB, Herzig SJ
Association between opioids prescribed to medical inpatients with pain and long-term opioid use.
This study’s objective was to identify the association between opioid exposure during a medical hospitalization and opioid use 6 to 12 months later. This observational cohort study used electronic health record data from 10 hospitals in the Cleveland Clinic Health System in 2016. Eligible patients were opioid-naïve adults with pain 18 years and older. The authors estimated the odds of long-term opioid use (defined as ≥2 prescriptions for at least 30 pills 6 to 12 months posthospitalization) by opioid exposure during the hospitalization. Among the 2971 patients in the study, 64% received opioids during their hospitalization, and 28% were discharged with opioids. A total of 3% of patients had long-term use with a higher pain score associated with greater odds of long-term use.
AHRQ-funded; HS026215.
Citation: Keenan KE, Rothberg MB, Herzig SJ .
Association between opioids prescribed to medical inpatients with pain and long-term opioid use.
South Med J 2021 Oct;114(10):623-29. doi: 10.14423/smj.0000000000001307..
Keywords: Opioids, Hospitalization, Pain, Substance Abuse, Medication
Lipira L, Leichtling G, Cook RR
Predictors of having naloxone in urban and rural Oregon findings from NHBS and the OR-HOPE study.
Investigators determined the proportion of people who had naloxone and identified predictors of naloxone ownership among two samples of people who inject drugs (PWID) who use opioids in Portland and rural Western Oregon. Using data from participants in two studies, they found that 61% of the Portland group and 30 % of the Oregon group had naloxone. The authors concluded that naloxone ownership was insufficient and highly variable among two samples of PWID who use opioids in Oregon. Further, people who use methamphetamine, males, and people experiencing homelessness may be at increased risk for not having naloxone, and syringe service programs may play a key role in improving access.
AHRQ-funded; HS026370.
Citation: Lipira L, Leichtling G, Cook RR .
Predictors of having naloxone in urban and rural Oregon findings from NHBS and the OR-HOPE study.
Drug Alcohol Depend 2021 Oct 1;227:108912. doi: 10.1016/j.drugalcdep.2021.108912..
Keywords: Opioids, Substance Abuse, Behavioral Health, Medication
Santos T, Lindrooth RC
Nonprofit hospital community benefits: collaboration with local health departments to address the drug epidemic.
Nonprofit hospitals (NFPs) are required to provide community benefits, which have been historically focused on provision of medical care, to keep their tax exemption status. To increase hospital investment in community health, the Patient Protection and Affordable Care Act required NFPs to conduct community health needs assessments and address identified needs. The objective of this study was to examine the association of NFP-local health department collaboration in local health planning targeting drug use, with drug-induced mortality.
AHRQ-funded; HS024959; HS025208; HS026116.
Citation: Santos T, Lindrooth RC .
Nonprofit hospital community benefits: collaboration with local health departments to address the drug epidemic.
Med Care 2021 Sep;59(9):829-35. doi: 10.1097/mlr.0000000000001595..
Keywords: Substance Abuse, Hospitals
Ko JY, Hirai AH, Owens PL
AHRQ Author: Owens PL
Neonatal abstinence syndrome and maternal opioid-related diagnoses: analysis of ICD-10-CM transition, 2013-2017.
Researchers sought to evaluate whether the transition from ICD-9-CM to ICD-10-CM may have affected surveillance on rates of neonatal abstinence syndrome (NAS), maternal opioid use disorder (OUD), and opioid-related diagnoses. Using HCUP data, they found that the ICD-10-CM transition did not appear to affect NAS. However, coding of maternal OUD alone may not capture the same population across the transition, potentially confounding the interpretation of trend data spanning this time period.
AHRQ-authored.
Citation: Ko JY, Hirai AH, Owens PL .
Neonatal abstinence syndrome and maternal opioid-related diagnoses: analysis of ICD-10-CM transition, 2013-2017.
Hosp Pediatr 2021 Aug;11(8):902-08. doi: 10.1542/hpeds.2021-005845..
Keywords: Healthcare Cost and Utilization Project (HCUP), Newborns/Infants, Opioids, Medication, Pregnancy, Substance Abuse
Bunting AM, Oser CB, Staton M
Pre-incarceration polysubstance use involving opioids: a unique risk factor of postrelease return to substance use.
This study explored pre-incarceration polysubstance use involving opioids as a unique risk factor for postrelease relapse to substance use. Data from a cohort of 502 justice-involved persons who were enrolled in a therapeutic community treatment program while incarcerated was used. Six unique polysubstance opioid patterns prior to incarceration were found using latent profile validation. Two of these profiles, primarily alcohol and primarily buprenorphine were at increased and accelerated risk for relapse postrelease relative to a lesser polysubstance use profile. Both profiles at increased risk had a pre-incarceration co-use of marijuana and nonmedical use of opioids but were unique in their respective near daily use of alcohol and nonmedical buprenorphine.
AHRQ-funded; HS026120.
Citation: Bunting AM, Oser CB, Staton M .
Pre-incarceration polysubstance use involving opioids: a unique risk factor of postrelease return to substance use.
J Subst Abuse Treat 2021 Aug;127:108354. doi: 10.1016/j.jsat.2021.108354..
Keywords: Opioids, Substance Abuse, Risk
Lillie KM, Shaw J, Jansen KJ
Buprenorphine/naloxone for opioid use disorder among Alaska Native and American Indian people.
Opioid-related disparities are magnified among Alaska Native and American Indian (ANAI) people. Yet, no outcome studies on medication for addiction treatment, an effective treatment in other populations, among ANAI people exist. The objective of this study was to identify variables associated with buprenorphine/naloxone retention among ANAI people with opioid use disorder (OUD). The investigators concluded that younger patients and those with co-occurring substance use remained at higher risk of discontinuing buprenorphine/naloxone treatment for OUD in this population of ANAI people.
AHRQ-funded; HS023207.
Citation: Lillie KM, Shaw J, Jansen KJ .
Buprenorphine/naloxone for opioid use disorder among Alaska Native and American Indian people.
J Addict Med 2021 Jul-Aug 01;15(4):297-302. doi: 10.1097/adm.0000000000000757..
Keywords: Opioids, Substance Abuse, Behavioral Health, Medication, Racial and Ethnic Minorities, Vulnerable Populations
Rogal S, Youk A, Agbalajobi O
Medication treatment of active opioid use disorder in veterans with cirrhosis.
Although opioid use disorder (OUD) is common in patients with cirrhosis, it is unclear how medication treatment for OUD (MOUD) is used in this population. In this study, the investigators aimed to assess the factors associated with MOUD and mortality in a cohort of Veterans with cirrhosis and OUD. The investigators found that few Veterans with active OUD and cirrhosis received MOUD, and those with alcohol use disorder, schizophrenia, and previous prescriptions for opioids were least likely to receive these effective therapies.
AHRQ-funded; HS019461.
Citation: Rogal S, Youk A, Agbalajobi O .
Medication treatment of active opioid use disorder in veterans with cirrhosis.
Am J Gastroenterol 2021 Jul;116(7):1406-13. doi: 10.14309/ajg.0000000000001228..
Keywords: Opioids, Substance Abuse, Medication
Clair K, Ijadi-Maghsoodi R, Nazinyan M
Veteran perspectives on adaptations to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic.
This paper looks at veterans’ perspectives on adaptations made to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic. Adaptations to services are described within a large residential rehabilitation program for under-resourced veterans; reports veterans’ experiences; and outlines successes and challenges encountered. Data was collected from two focus groups with nine veterans in the program. The groups highlighted experiences of inconsistent communication about residential policies, interruptions to medical and addiction services, and feelings of confinement and social isolation.
AHRQ-funded; HS026407.
Citation: Clair K, Ijadi-Maghsoodi R, Nazinyan M .
Veteran perspectives on adaptations to a VA residential rehabilitation program for substance use disorders during the novel coronavirus pandemic.
Community Ment Health J 2021 Jul;57(5):801-07. doi: 10.1007/s10597-021-00810-z..
Keywords: Substance Abuse, Rehabilitation, COVID-19, Healthcare Delivery, Access to Care, Patient Experience
Fan T, Lee G
AHRQ Author: Fan T
Interventions for tobacco smoking cessation in adults, including pregnant persons.
This AHRQ-authored Putting Preventions in Practice quiz has three questions and answers on the US Preventive Services Task Force final recommendation on interventions for tobacco smoking cessation in adults, including pregnant persons. A case study is presented with questions on the best behavioral interventions, e-cigarette use, and pharmacotherapy for tobacco cessation in pregnant persons. References are also provided at the end of the answers.
AHRQ-authored.
Citation: Fan T, Lee G .
Interventions for tobacco smoking cessation in adults, including pregnant persons.
Am Fam Physician 2021 Jun 15;103(12):753-54..
Keywords: U.S. Preventive Services Task Force (USPSTF), Tobacco Use, Prevention, Case Study, Pregnancy, Women, Substance Abuse
Simon CB, Klein JW, Bradley KA
Primary care patients with opioid use disorder have a high prevalence of pain and mental health and other substance use disorders.
One potential challenge of treating OUD in primary care is comorbidity. Mental health and substance use disorders and chronic pain are common in patients with Opioid Use Disorders (OUDs) in specialty OUD treatment settings and on confidential surveys, but the prevalence of such comorbidity in primary care patients with OUD has not been confirmed. This brief report addressed that gap.
AHRQ-funded; HS023173.
Citation: Simon CB, Klein JW, Bradley KA .
Primary care patients with opioid use disorder have a high prevalence of pain and mental health and other substance use disorders.
J Gen Intern Med 2021 Jun;36(6):1799-801. doi: 10.1007/s11606-020-05820-3..
Keywords: Opioids, Medication, Substance Abuse, Behavioral Health, Primary Care
Zubiago J, Murphy M, Guardado R
Increased HIV testing in people who use drugs hospitalized in the first wave of the COVID-19 pandemic.
During the COVID-19 pandemic, due to lapses in harm reduction services, several public health experts forecasted subsequent increases in diagnosis of HIV in PWUD. As many inpatient hospitals reworked patient flow during the COVID-19 surge, the investigators hypothesized that HIV testing in PWUD would decrease. To answer this question, they compiled a deidentified list of hospitalized patients with electronic medical record indicators of substance use-a positive urine toxicology screen, prescribed medications to treat opioid use disorder, a positive CIWA score, or a positive CAGE score-admitted between January, 2020 and August, 2020.
AHRQ-funded; HS026008.
Citation: Zubiago J, Murphy M, Guardado R .
Increased HIV testing in people who use drugs hospitalized in the first wave of the COVID-19 pandemic.
J Subst Abuse Treat 2021 May;124:108266. doi: 10.1016/j.jsat.2020.108266..
Keywords: Human Immunodeficiency Virus (HIV), Opioids, Substance Abuse, Alcohol Use, Hospitalization, COVID-19, Public Health, Screening
Anderson KE, Saloner B, Eckstein J
Quality of buprenorphine care for insured adults with opioid use disorder.
This retrospective cohort study evaluated the quality of treatment for insured adults with opioid use disorder (OUD) in the United States. A total of 45,210 commercially insured and Medicare Advantage (MA) enrollees 18 years or older from the OptumLabs Data Warehouse database with an OUD diagnosis in 2018 were analyzed. The treatment analyzed was use of buprenorphine. Only 1 in 10 eligible individuals with OUD initiated buprenorphine within 365 days of diagnosis with 2850 individuals (6.3%) initiating buprenorphine within 14 days of diagnosis. Of the 4600 individuals who received buprenorphine, half were maintained in care with 180 days or more of covered treatment. Treatment quality was generally lower for individuals with MA compared with commercial coverage as well as Hispanic and Black adults compared with White adults.
AHRQ-funded; HS000029.
Citation: Anderson KE, Saloner B, Eckstein J .
Quality of buprenorphine care for insured adults with opioid use disorder.
Med Care 2021 May;59(5):393-401. doi: 10.1097/mlr.0000000000001530..
Keywords: Opioids, Medication, Substance Abuse, Quality of Care
Bunting AM, Frank D, Arshonsky J
Socially-supportive norms and mutual aid of people who use opioids: an analysis of Reddit during the initial COVID-19 pandemic.
This study looked at the effect big events like the COVID-19 pandemic can have on transforming social structures, social interactions, and social norms. The social media site Reddit.com was used to collect data on the impact of COVID-19 and opioid use. Posts from March to May 2020 were collected from the two most popular opioid subreddits. Out of 2000 posts, 300 were found to be relevant to the study. The pandemic led to robust social support and mutual aid on Reddit including advice on coping with social isolation, withdrawal, managing cravings, and accessing recovery resources.
AHRQ-funded; HS026120.
Citation: Bunting AM, Frank D, Arshonsky J .
Socially-supportive norms and mutual aid of people who use opioids: an analysis of Reddit during the initial COVID-19 pandemic.
Drug Alcohol Depend 2021 May 1;222:108672. doi: 10.1016/j.drugalcdep.2021.108672..
Keywords: Opioids, Medication, Substance Abuse, COVID-19, Infectious Diseases, Social Media
Baillargeon J, Polychronopoulou E, Kuo YF
The impact of substance use disorder on COVID-19 outcomes.
The goal of this study was to examine the impact of substance use disorder on the risk of hospitalization, complications, and mortality among adult patients diagnosed as having COVID-19. Using data from the TriNetX Research Network database, primary analysis showed that substance use disorder was associated with an increased risk of hospitalization, ventilator use, and mortality. These findings suggest that COVID-19 patients with substance use disorders are at increased risk for adverse outcomes.
AHRQ-funded; HS026133.
Citation: Baillargeon J, Polychronopoulou E, Kuo YF .
The impact of substance use disorder on COVID-19 outcomes.
Psychiatr Serv 2021 May;72(5):578-81. doi: 10.1176/appi.ps.202000534..
Keywords: COVID-19, Substance Abuse, Hospitalization, Mortality, Risk
Griffith KN, Feyman Y, Auty SG
County-level data on U.S. opioid distributions, demographics, healthcare supply, and healthcare access.
Researchers created a dataset to provide a new level of precision that may be leveraged by scholars, policymakers, or data journalists who are interested in studying the opioid epidemic. Other researchers may use this dataset to identify patterns in opioid distribution over time and characteristics of counties or states which were disproportionately impacted by the epidemic. These data may also be joined with other sources to facilitate studies on the relationships between opioid pill volume and a wide variety of health, economic, and social outcomes.
AHRQ-funded; HS026395.
Citation: Griffith KN, Feyman Y, Auty SG .
County-level data on U.S. opioid distributions, demographics, healthcare supply, and healthcare access.
Data Brief 2021 Apr;35:106779. doi: 10.1016/j.dib.2021.106779.
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Keywords: Opioids, Medication, Substance Abuse
Tsui JI, Akosile MA, Lapham GT
Prevalence and medication treatment of opioid use disorder among primary care patients with hepatitis C and HIV.
Hepatitis C and HIV are associated with opioid use disorders (OUD) and injection drug use. Medications for OUD can prevent the spread of HCV and HIV. The objective of this retrospective observational cohort study was to describe the prevalence of documented OUD, as well as receipt of office-based medication treatment, among primary care patients with HCV or HIV.
AHRQ-funded; HS026369.
Citation: Tsui JI, Akosile MA, Lapham GT .
Prevalence and medication treatment of opioid use disorder among primary care patients with hepatitis C and HIV.
J Gen Intern Med 2021 Apr;36(4):930-37. doi: 10.1007/s11606-020-06389-7..
Keywords: Opioids, Medication, Substance Abuse, Behavioral Health, Hepatitis, Human Immunodeficiency Virus (HIV), Primary Care
Anderson KE, Alexander GC, Niles L
Quality of preventive and chronic illness care for insured adults with opioid use disorder.
Investigators sought to measure quality of non-opioid use disorder (OUD) preventive and chronic illness care and care coordination for individuals with OUD compared with individuals without OUD. They used deidentified data on outpatients throughout the United States from claims for commercially insured and Medicare Advantage enrollees aged 18 years or older with diagnosis codes for OUD. They found that individuals with OUD have moderately lower quality of care across preventive and chronic illness care and care coordination for non-OUD care compared with individuals without OUD. They recommended more attention to measurement and improvement of non-OUD care for these individuals.
AHRQ-funded; HS000029.
Citation: Anderson KE, Alexander GC, Niles L .
Quality of preventive and chronic illness care for insured adults with opioid use disorder.
JAMA Netw Open 2021 Apr;4(4):e214925. doi: 10.1001/jamanetworkopen.2021.4925..
Keywords: Opioids, Medication, Substance Abuse, Quality Indicators (QIs), Quality of Care, Behavioral Health, Chronic Conditions, Prevention
Afshar M, Sharma B, Bhalla S
External validation of an opioid misuse machine learning classifier in hospitalized adult patients.
This study looks at new methods to make opioid misuse screening in hospitals less resource-intensive, which causes it to occur rarely. The objective of this study is to externally validate the author’s previously published and open-source machine learning classifier by implementing it a different hospital to identify cases of opioid misuse. An observational cohort of 56,227 adult hospitalizations from October 2017 to December 2019 was used during a hospital-wide substance use screening program with manual screening. A manually completed Drug Abuse Screening Test served as the reference standard to validate a convolutional neural network (CNN) classified with coded word embedding features to capture electronic health record (EHR) clinical notes. Manual screening was completed in 67.8% of patients with 1.1% identified with opioid misuse. The opioid misuse classifier had good discrimination during external validation and may help overcome manual screening barriers.
AHRQ-funded; HS026385.
Citation: Afshar M, Sharma B, Bhalla S .
External validation of an opioid misuse machine learning classifier in hospitalized adult patients.
Addict Sci Clin Pract 2021 Mar 17;16(1):19. doi: 10.1186/s13722-021-00229-7..
Keywords: Opioids, Medication, Substance Abuse, Screening, Hospitalization
Nourjah P, Kato E
AHRQ Author: Nourjah P, Kato E
"One size does not fit all" and other lessons learned from grants for implementation of the AHRQ medication assisted treatment for opioid use disorder in rural primary care.
This article summarizes lessons learned from five AHRQ grants to implement Medication for Opioid Use Disorder (MOUD) in rural primary care practices. The experience of these projects suggests that recruiting providers in rural areas and engaging them to initiate and sustain provision of MOUD is very difficult. Implementation of MOUD in rural primary care is challenging but success is more likely if implementers are attentive to the needs of individual providers, are flexible and can tailor implementation to the local situation, and can provide on-going support.
AHRQ-authored.
Citation: Nourjah P, Kato E .
"One size does not fit all" and other lessons learned from grants for implementation of the AHRQ medication assisted treatment for opioid use disorder in rural primary care.
Subst Abus 2021;42(2):136-39. doi: 10.1080/08897077.2021.1891600..
Keywords: Implementation, Opioids, Substance Abuse, Primary Care, Rural Health, Medication
Cole ES, DiDomenico E, Green S
The who, the what, and the how: a description of strategies and lessons learned to expand access to medications for opioid use disorder in rural America.
This study looked at the problems of treatment access for opioid use disorder (OUD) in rural areas within the United States. Providers must complete 8-24 hours of training to obtain the Drug Addiction Treatment Act (DATA) 2000 waiver to have the legal authority to prescribe buprenorphine. The authors executed 5 AHRQ-funded dissemination and implementation grants to study and address barriers to providing Medications for Opioid Use Disorder Treatment (MOUD), including psychosocial supports. Obtaining the DATA 2000 waiver was found to be just one component of meaningful treatment using MOUD, and there are other significant barriers that providers face daily. The researchers’ initiatives and common lessons learned across their grants are summarized and recommendations are offered how primary care providers can be better supported to expand access to MOUD across rural America.
AHRQ-funded.
Citation: Cole ES, DiDomenico E, Green S .
The who, the what, and the how: a description of strategies and lessons learned to expand access to medications for opioid use disorder in rural America.
Subst Abus 2021;42(2):123-29. doi: 10.1080/08897077.2021.1891492..
Keywords: Opioids, Medication, Primary Care, Rural Health, Substance Abuse, Access to Care
Rapoport AB, Fine DR, Manne-Goehler JM
High inpatient health care utilization and charges associated with injection drug use-related infections: a cohort study, 2012-2015.
This study described the characteristics of patients hospitalized with injection drug use-related infection over a multiyear period in a region highly impacted by the opioid epidemic. Findings revealed a longer average length of stay with subsequent higher cost, a higher percentage of 30-day readmissions, disproportionate public payer mix representation, and higher rates of discharge to alternate facilities for ongoing care as compared with the total inpatient cohort.
AHRQ-funded; HS026215.
Citation: Rapoport AB, Fine DR, Manne-Goehler JM .
High inpatient health care utilization and charges associated with injection drug use-related infections: a cohort study, 2012-2015.
Open Forum Infect Dis 2021 Mar;8(3):ofab009. doi: 10.1093/ofid/ofab009..
Keywords: Opioids, Substance Abuse, Hospitalization, Healthcare Costs, Healthcare Utilization
Wyse JJ, Lovejoy J, Holloway J
Patients' perceptions of the pathways linking chronic pain with problematic substance use.
This study examined how patients with chronic pain perceive their relationship between their substance use disorder (SUD) and chronic pain. About one-half of patients with SUDs experience chronic pain. The authors conducted qualitative interviews with 34 patients involved in SUD treatment who were also diagnosed with chronic pain. The interviews revealed 3 primary pathways. One group described SUD as development independently from their experiences of chronic pain. A second group described turning to substances to self-manage or cope with the chronic pain. A third group described encounters with opioid medications as the causal agent.
AHRQ-funded; HS026370.
Citation: Wyse JJ, Lovejoy J, Holloway J .
Patients' perceptions of the pathways linking chronic pain with problematic substance use.
Pain 2021 Mar;162(3):787-93. doi: 10.1097/j.pain.0000000000002077..
Keywords: Opioids, Substance Abuse, Medication, Pain, Chronic Conditions