Gender Differences in Risk Factors for Aberrant Prescription Opioid Use

Overview

Journal J Pain

Specialties Neurology
Psychiatry

Date 2009 Dec 1

PMID 19944648

Citations 60

Authors

Robert N Jamison

Stephen F Butler

Simon H Budman

Robert R Edwards

Ajay D Wasan

Affiliations

Soon will be listed here.

Abstract

Unlabelled: This is a longitudinal predictive study to examine gender differences in the clinical correlates of risk for opioid misuse among chronic pain patients prescribed opioids for pain. Two hundred seventy-five male and 335 female patients prescribed opioids for chronic noncancer pain were asked to complete a series of baseline questionnaires, including the revised Screener and Opioid Assessment for Pain Patients (SOAPP-R). After 5 months, the subjects were administered a structured prescription drug use interview (Prescription Drug Use Questionnaire; PDUQ) and submitted a urine sample for toxicology assessment. Their treating physicians also completed a substance misuse behavior checklist (Prescription Opioid Therapy Questionnaire; POTQ). At 5-month follow-up, women showed higher scores on the PDUQ (P < .05), whereas men had a higher incidence of physician-rated aberrant drug behavior on the POTQ (P < .05). An item analysis of the SOAPP-R, PDUQ, and POTQ showed that women tended to score higher on items relating to psychological distress, whereas the male patients tended to report having more legal and behavioral problems. These results suggest that risk factors associated with prescription opioid misuse may differ between men and women.

Perspective: Understanding gender differences in substance abuse risk among chronic pain patients is important for clinical assessment and treatment. This study suggests that women are at greater risk to misuse opioids because of emotional issues and affective distress, whereas men tend to misuse opioids because of legal and problematic behavioral issues.

Citing Articles

Inbred rat heredity and sex affect oral oxycodone self-administration and augmented intake in long sessions: correlations with anxiety and novelty-seeking.

Sharp B, Leng S, Huang J, Jones C, Williams R, Chen H PLoS One. 2025; 20(3):e0314777.

PMID: 40063602 PMC: 11892884. DOI: 10.1371/journal.pone.0314777.

Male and female behavioral variability and morphine response in C57BL/6J, DBA/2J, and their BXD progeny following chronic stress exposure.

Morel C, Parise L, Van der Zee Y, Issler O, Cai M, Browne C Sci Rep. 2024; 14(1):30785.

PMID: 39730457 PMC: 11680947. DOI: 10.1038/s41598-024-80767-7.

Sex differences in comorbid pain and opioid use disorder: A scoping review.

DeVito E, Ameral V, Sofuoglu M Br J Clin Pharmacol. 2024; 90(12):3067-3083.

PMID: 39168150 PMC: 11604518. DOI: 10.1111/bcp.16218.

Obekpa E, McCurdy S, Schick V, Markham C, Gallardo K, Wilkerson J Front Public Health. 2023; 11:1284192.

PMID: 38054070 PMC: 10694473. DOI: 10.3389/fpubh.2023.1284192.

Risk Factors Associated With Prolonged Opioid Use After Revision Total Shoulder Arthroplasty.

Abed V, Khalily C, Landy D, Lemaster N, Stone A J Am Acad Orthop Surg Glob Res Rev. 2023; 7(11).

PMID: 37976449 PMC: 10659687. DOI: 10.5435/JAAOSGlobal-D-23-00118.

References

Michna E, Ross E, Hynes W, Nedeljkovic S, Soumekh S, Janfaza D . Predicting aberrant drug behavior in patients treated for chronic pain: importance of abuse history. J Pain Symptom Manage. 2004; 28(3):250-8. DOI: 10.1016/j.jpainsymman.2004.04.007. View

Arendt-Nielsen L, Bajaj P, Drewes A . Visceral pain: gender differences in response to experimental and clinical pain. Eur J Pain. 2004; 8(5):465-72. DOI: 10.1016/j.ejpain.2004.03.001. View

Katon W, Egan K, Miller D . Chronic pain: lifetime psychiatric diagnoses and family history. Am J Psychiatry. 1985; 142(10):1156-60. DOI: 10.1176/ajp.142.10.1156. View

Webster L, Webster R . Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the Opioid Risk Tool. Pain Med. 2005; 6(6):432-42. DOI: 10.1111/j.1526-4637.2005.00072.x. View

Turk D, Swanson K, Gatchel R . Predicting opioid misuse by chronic pain patients: a systematic review and literature synthesis. Clin J Pain. 2008; 24(6):497-508. DOI: 10.1097/AJP.0b013e31816b1070. View

Portenoy R, Foley K . Chronic use of opioid analgesics in non-malignant pain: report of 38 cases. Pain. 1986; 25(2):171-186. DOI: 10.1016/0304-3959(86)90091-6. View

Mackenzie C, Gekoski W, Knox V . Age, gender, and the underutilization of mental health services: the influence of help-seeking attitudes. Aging Ment Health. 2006; 10(6):574-82. DOI: 10.1080/13607860600641200. View

Butler S, Budman S, Fernandez K, Jamison R . Validation of a screener and opioid assessment measure for patients with chronic pain. Pain. 2004; 112(1-2):65-75. DOI: 10.1016/j.pain.2004.07.026. View

Carise D, Dugosh K, McLellan A, Camilleri A, Woody G, Lynch K . Prescription OxyContin abuse among patients entering addiction treatment. Am J Psychiatry. 2007; 164(11):1750-6. PMC: 2785002. DOI: 10.1176/appi.ajp.2007.07050252. View

10.

Walitzer K, Dearing R . Gender differences in alcohol and substance use relapse. Clin Psychol Rev. 2006; 26(2):128-48. DOI: 10.1016/j.cpr.2005.11.003. View

11.

Hojsted J, Sjogren P . Addiction to opioids in chronic pain patients: a literature review. Eur J Pain. 2006; 11(5):490-518. DOI: 10.1016/j.ejpain.2006.08.004. View

12.

Sullivan M, Edlund M, Steffick D, Unutzer J . Regular use of prescribed opioids: association with common psychiatric disorders. Pain. 2005; 119(1-3):95-103. DOI: 10.1016/j.pain.2005.09.020. View

13.

Fishbain D, Rosomoff H, Rosomoff R . Drug abuse, dependence, and addiction in chronic pain patients. Clin J Pain. 1992; 8(2):77-85. DOI: 10.1097/00002508-199206000-00003. View

14.

Becker W, Sullivan L, Tetrault J, Desai R, Fiellin D . Non-medical use, abuse and dependence on prescription opioids among U.S. adults: psychiatric, medical and substance use correlates. Drug Alcohol Depend. 2007; 94(1-3):38-47. DOI: 10.1016/j.drugalcdep.2007.09.018. View

15.

Simoni-Wastila L, Ritter G, Strickler G . Gender and other factors associated with the nonmedical use of abusable prescription drugs. Subst Use Misuse. 2004; 39(1):1-23. DOI: 10.1081/ja-120027764. View

16.

Joranson D, Ryan K, Gilson A, Dahl J . Trends in medical use and abuse of opioid analgesics. JAMA. 2001; 283(13):1710-4. DOI: 10.1001/jama.283.13.1710. View

17.

Tsang A, Von Korff M, Lee S, Alonso J, Karam E, Angermeyer M . Common chronic pain conditions in developed and developing countries: gender and age differences and comorbidity with depression-anxiety disorders. J Pain. 2008; 9(10):883-91. DOI: 10.1016/j.jpain.2008.05.005. View

18.

Michna E, Jamison R, Pham L, Ross E, Janfaza D, Nedeljkovic S . Urine toxicology screening among chronic pain patients on opioid therapy: frequency and predictability of abnormal findings. Clin J Pain. 2007; 23(2):173-9. DOI: 10.1097/AJP.0b013e31802b4f95. View

19.

Wasan A, Correll D, Kissin I, OShea S, Jamison R . Iatrogenic addiction in patients treated for acute or subacute pain: a systematic review. J Opioid Manag. 2007; 2(1):16-22. DOI: 10.5055/jom.2006.0003. View

20.

Chabal C, Erjavec M, Jacobson L, Mariano A, Chaney E . Prescription opiate abuse in chronic pain patients: clinical criteria, incidence, and predictors. Clin J Pain. 1997; 13(2):150-5. DOI: 10.1097/00002508-199706000-00009. View