Evidence map›Paper›PMID 30724760›Full record

Trial reportJournal of addiction medicine

Severity of Analgesic Dependence and Medication-overuse Headache.

Christofer Lundqvist, Michael Gossop, Michael Bjørn Russell, Jørund Straand, Espen Saxhaug Kristoffersen

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of addiction medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01314768 (RCT of Structured Brief Intervention for Medication Overuse Headache Versus Business as Usual), which is not on this map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT01314768 nacompletednot on this map

RCT of Structured Brief Intervention for Medication Overuse Headache Versus Business as Usual

TypeinterventionalSponsorUniversity Hospital, AkershusRan2011 to 2013Enrolled123ConditionsMedication-overuse Headache, Chronic HeadacheArmsBrief intervention, Business as usual, Screening and outcome evaluation only
3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Article
  6. Awareness of medication-overuse headache in Hail, Saudi Arabia.Journal of family medicine and primary care · 2026
    Article
  7. Article
  8. Article
  9. Article
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Christofer LundqvistResearch Centre, Akershus University Hospital, Lørenskog (CL, ESK); Department of Neurology, Akershus University Hospital, Nordbyhagen (CL, ESK); Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Nordbyhagen, Norway (CL, MBR); National Addiction Centre, King's College, London, UK (MG); Head and Neck Research Group, Research Centre, Akershus University Hospital, Lørenskog (MBR); Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway (JS, ESK).
Michael Gossop
Michael Bjørn Russell
Jørund Straand
Espen Saxhaug Kristoffersen

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsMedication-overuse headache (MOH) is a common chronic headache caused by overuse of headache analgesics. It has similarities with substance dependence disorders. The treatment of choice for MOH is withdrawal of the offending analgesics. Behavioral brief intervention treatment using methods adapted from substance misuse settings is effective. Here we investigate the severity of analgesics dependence in MOH using the Severity of Dependence Scale (SDS), validate the SDS score against formal substance dependence diagnosis based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) and examine whether the SDS predicts successful withdrawal.

methodsRepresentative recruitment from the general population; 60 MOH patients, 15 chronic headache patients without medication overuse and 25 population controls. Headaches were diagnosed using the International Classification of Headache Disorders, medication use was assessed and substance dependence classified according to the DSM-IV. The SDS was scored by interviewers blinded to patient group. Descriptive statistics were used and validity of the SDS score assessed against a substance dependence diagnosis using ROC analysis.

resultsSixty-two percent of MOH patients overused simple analgesics, 38% centrally acting analgesics (codeine, opiates, triptans). Fifty percent of MOH patients were classified as DSM-IV substance dependent. Centrally active medication and high SDS scores were associated with higher proportions of dependence. ROC analysis showed SDS scores accurately identified dependence (area under curve 88%). Lower SDS scores were associated with successful withdrawal (P = 0.004).

conclusionsMOH has characteristics of substance dependence which should be taken into account when choosing treatment strategy.

trial registrationBased on data collected in previously reported randomized BIMOH trial (; in the present manuscript, Clinical trials registration number: NCT01314768). The present part, however, represents observational data and is not a treatment trial.

Indexed as

Severity of Illness IndexAdultAnalgesicsBehavior, AddictiveDiagnostic and Statistical Manual of Mental DisordersFemaleHeadache Disorders, SecondaryHumansLogistic ModelsMaleNorwayROC CurveSubstance-Related DisordersAnalgesics

Identifiers

PMID30724760
PMCPMC6791494

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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.