(108) Self-Reported Challenges Obtaining Ongoing Prescription Opioids Among Australians with Chronic Non-Cancer Pain

Sunday, August 28, 2022

8:00 AM – 1:45 PM CEST

Location: Hall C

Publication Number: 1153

Presenting Author(s)

Ria E. Hopkins, MPH, BHS
– National Drug and Alcohol Research Centre, UNSW Sydney, UNSW Sydney, Randwick, New South Wales, Australia

Co-Author(s)

Gabrielle Campbell, BA(Psych), MCrim, PhD
– Senior Research Fellow, School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
Louisa Degenhardt, BA(Psych), MPsychol(Clinical), PhD
– Scientia Professor, National Drug and Alcohol Research Centre, UNSW Sydney, Randwick, New South Wales, Australia
Nicholas Lintzeris, BMedSci, MBBS, PhD
– Associate Professor, Central Clinical School, University of Sydney, Sydney, New South Wales, Australia
Briony Larance, BSc(Psych)(Hons), PhD
– Postdoctoral Senior Research Fellow, School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia
Suzanne Nielsen, BPharmSc(Hons), PhD
– Associate Professor, Monash Addiction Research Centre, Monash University, Melbourne, Victoria, Australia
Natasa Gisev, PhD
– University of New South Wales, Randwick, New South Wales, Australia

Background: Policies to address opioid-related harms include strategies to reduce opioid prescribing for new and ongoing pain management. Concerns have been raised that people with chronic non-cancer pain (CNCP) may be adversely affected by prescribing restrictions, and by involuntary tapering and cessation of opioids.

Objectives: To describe self-reported challenges obtaining prescription opioids among people prescribed opioids long-term for CNCP and explore associations with participant and treatment characteristics.

Methods: This cross-sectional study analysed data from a longitudinal cohort study of 1,514 Australians prescribed restricted opioids for CNCP. In 2018, 861 participants who took part in Year-5 follow-up and reported past 12-month opioid use were asked about challenges obtaining opioid prescriptions, including prescriber access-related difficulties obtaining prescriptions or having opioids tapered or ceased involuntarily. Associations between challenges and demographics, treatment characteristics including daily opioid dose as oral morphine equivalent milligrams (OME mg/day), substance use disorder (SUD), and opioid dependence were assessed using logistic regression.

Results: Overall, 285 (31%) participants reported at least one challenge, predominantly prescriber access-related difficulties (n=177/285; 62%). Prescriber access-related difficulties were associated with younger age (adjustedOR 0.94 per year increase, 95%CI 0.93-0.96), and past 12-month pharmaceutical opioid dependence (adjustedOR 2.25, 95%CI 1.33-3.80). Involuntary opioid tapering or cessation was reported by 73 participants (26% of those reporting challenges) and was associated with lifetime SUD diagnosis (adjustedOR 2.15, 95%CI 1.15-3.90), and opioid doses of ≥200 OME mg/day (adjustedOR 2.41, 95%CI 1.18-4.88).

Conclusions: One-third of participants with CNCP reported experiencing challenges obtaining prescriptions for opioids or having their opioid medicines involuntarily reduced within a 12-month period. Given increasing restrictions to opioid access, it is important that strategies to reduce opioid-related harms are balanced against the current treatment needs of people prescribed opioids long-term for CNCP.