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Factors Help Predict Continued Opioid Use for Back Pain

Last Updated: January 21, 2010.

Patients with chronic back pain are more likely to use opioid analgesics long term if they smoke and had non-surgical treatment, according to a study in the January issue of the Journal of Pain.

THURSDAY, Jan. 21 (HealthDay News) -- Patients with chronic back pain are more likely to use opioid analgesics long term if they smoke and had non-surgical treatment, according to a study in the January issue of the Journal of Pain.

Erin E. Krebs, M.D., of the Indiana University School of Medicine in Indianapolis, and colleagues analyzed characteristics associated with long-term opioid use using data from 2,110 patients with back pain due to lumbar disc herniation or spinal stenosis.

The researchers found that 42.3 percent of patients reported that they currently used opioids for their spine condition. Of these patients, 25 percent reported continued opioid use at 12 months, and 21 percent reported continued opioid use at 24 months. After adjusting for possible confounding factors, long-term opioid use was predicted by smoking (relative risks, 1.9 at 12 months and 1.5 at 24 months) and non-surgical treatment (relative risks, 1.7 at 12 months and 1.8 at 24 months). For patients not using opioids at baseline, there were no significant predictors of incident use.

"In conclusion, non-surgical treatment and smoking independently predicted long-term continued opioid use," the authors write. "The greater use of long-term opioids among patients who received non-surgical therapy may be a factor worth considering in surgical decision-making for patients with disc herniation or spinal stenosis."

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