ArticleThe Clinical journal of pain2014
Do patient-perceived pros and cons of opioids predict sustained higher-dose use?
Article in The Clinical journal of pain, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03748862 (The Effect of Primary Care Opioid Taper Plans and Their Components on Sustained Opioid Taper and Opioid Discontinuation), which is not on this map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effect of Primary Care Opioid Taper Plans and Their Components on Sustained Opioid Taper and Opioid Discontinuation
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- Guideline
- Lay perspectives of the open-label placebo rationale: a qualitative study of participants in an experimental trial.BMJ open · 2021Trial
- Article
- Difficulties with prescribed opioids: a cross-sectional survey of primary care patients in England, United Kingdom.Pain reports · 2025Article
- Pharmacological Strategies to Decrease Long-Term Prescription Opioid Use: A Systematic Review.Journal of clinical medicine · 2024Review
- Predictive Model for Opioid Use Disorder in Chronic Pain: A Development and Validation Study.Biomedicines · 2024Article
- Epigenetic and sex differences in opioid use disorder in chronic pain: A real-world study linked with OPRM1 DNA methylation.Addiction biology · 2024Article
- Adverse Events of the Long-Term Use of Opioids for Chronic Non-cancer Pain: A Narrative Review.Cureus · 2024Review
- Perspectives of pain specialists, patients, and family members on long-term opioid use for chronic non-cancer pain: a qualitative study.BMC anesthesiology · 2021Article
- Health(care) in the Crisis: Reflections in Science and Society on Opioid Addiction.International journal of environmental research and public health · 2021Review
- Pain rehabilitation's dual power: Treatment for chronic pain and prevention of opioid-related risks.The American psychologist · 2020Article
- Treatment Patterns of Newly Diagnosed Rheumatoid Arthritis Patients from a Commercially Insured Population.Rheumatology and therapy · 2018Article
- Reducing Long-term Opioid Use in the Veterans Health Administration.Journal of general internal medicine · 2018Article
- Smoking Status and Opioid-related Problems and Concerns Among Men and Women on Chronic Opioid Therapy.The Clinical journal of pain · 2017Article
- Current State of Opioid Therapy and Abuse.Current pain and headache reports · 2016Review
- Neurological complications associated with epidural steroid injections.Current pain and headache reports · 2015Review
- Article
- Review
- Long-term use of opioids for complex chronic pain.Best practice & research. Clinical rheumatology · 2013Review
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 2 countries.
Funding
Abstract
objectivesChronic opioid therapy (COT) is associated with various adverse outcomes, especially at higher doses, yet little is known about predictors of sustained higher-dose COT. This study aimed to ascertain, among higher-dose COT patients, the association of patient-perceived pros and cons of opioids with continued higher-dose use 1 year later.
methodsPatients (N=1229) in 2 large health plans prescribed ≥50 mg morphine-equivalent dose (MED) per day for chronic noncancer pain completed a survey assessing opioid benefits and harms. The Prescribed Opioid Difficulties Scale questionnaire assessed psychosocial problems, concerns, benefits, and side effects related to opioid use. Logistic regression models estimated the associations of the reported benefits and problems with higher-dose continuation (≥50 mg MED/d) versus dose reduction (<50 mg MED/d) 1 year later.
resultsOver 80% of participants continued higher-dose opioid use at 1 year, regardless of reported problems, concerns, side effects, pain reduction, or perceived helpfulness. Higher scores on the Prescribed Opioid Difficulties Scale Problems subscale (odds ratio=0.79, 95% confidence interval, 0.68-0.92) and Concerns subscale (odds ratio=0.76, 95% confidence interval, 0.65-0.90) were negatively associated with higher-dose use 1 year later. Other baseline measures (opioid helpfulness, reduction in pain, number of side effects, and side effect bothersomeness) were not significantly associated with continued higher-dose use. DISCUSSION: The large majority of patients continued using higher-dose opioids regardless of baseline characteristics. These findings suggest the difficulty of reducing opioid dose among chronic higher-dose opioid users.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.