Abstract

Objective

In light of the opioid epidemic, there is a need to identify factors that predict aberrant opioid behaviors including misuse and abuse. Impulsivity has been extensively studied in addiction literature, but not in the context of opioid misuse. Hence, this study aimed to identify which of the impulsivity facets (negative urgency, positive urgency, sensation seeking, lack of perseverance, and lack of premeditation) would predict current aberrant opioid-related behaviors in patients with chronic pain.

Methods

Data were collected through an online survey from patients with chronic pain who visited a tertiary pain clinic. Patients were predominately female (74%), middle aged (M = 55 years), and White/Caucasian (84%). Upon consent, they completed a series of surveys including UPPS-P Impulsive Behavior Scale, the Current Opioid misuse Measure, Pain Catastrophizing Scale, PROMIS-anxiety, depression, and physical function, and a 0-10 numerical pain rating scale. Ordinal regression analyses were conducted to test study hypotheses.

Results

Contrary to expectations, only lack of premeditation predicted higher odds of aberrant opioid-related behaviors in the past 30 days, after controlling for known covariates, and explained 26% of variance. Interestingly, lack of premeditation together with pain catastrophizing as a covariate explained 56% of the variance in aberrant opioid-related behaviors.

Discussion

The current study is the first to identify a potential role of lack of premeditation as an impulsivity facet predicting aberrant opioid-related behaviors among patients with chronic pain.

中文翻译：

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缺乏预谋可预测慢性疼痛患者与处方阿片类药物相关的异常行为：一项横断面研究

摘要

客观的

鉴于阿片类药物的流行，有必要确定预测异常阿片类药物行为的因素，包括滥用和滥用。冲动已在成瘾文献中得到广泛研究，但不是在阿片类药物滥用的背景下。因此，本研究旨在确定哪些冲动方面（消极紧迫性、积极紧迫性、寻求感觉、缺乏毅力和缺乏预谋）可以预测慢性疼痛患者当前异常的阿片类药物相关行为。

方法

数据是通过访问三级疼痛诊所的慢性疼痛患者的在线调查收集的。患者主要是女性 (74%)、中年人 ( M  = 55 岁) 和白人/高加索人 (84%)。经同意，他们完成了一系列调查，包括 UPPS-P 冲动行为量表、当前阿片类药物滥用量表、疼痛灾难化量表、PROMIS 焦虑、抑郁和身体机能，以及 0-10 数字疼痛等级量表。进行序数回归分析以检验研究假设。

结果

与预期相反，在控制已知协变量并解释 26% 的方差后，只有缺乏预谋才能预测过去 30 天内出现异常阿片类药物相关行为的几率更高。有趣的是，缺乏预谋以及作为协变量的灾难性疼痛解释了异常阿片类药物相关行为差异的 56%。

讨论

目前的研究首次确定了缺乏预谋作为预测慢性疼痛患者异常阿片类药物相关行为的冲动方面的潜在作用。