- In this meta-analysis, younger people, men, people with mental-health diagnoses, and those with any substance use were likelier to commence opioid misuse after being prescribed opioids for pain.
Why this matters
- Targeting higher-risk patients for alternative pain treatments might curb misuse.
- Not enough is known about risk factors for opioid misuse, including among the opioid-naive.
- Among 16 dichotomous risk factors were:
- Male sex: OR, 1.23 (95% CI, 1.10-1.36);
- Any substance use: OR, 3.55 (95% CI, 2.62-4.82); and
- Any mental-health diagnosis: OR, 2.45 (95% CI, 1.91-3.15).
- Among 6 continuous risk factors were younger age, increased pain, longer opioid exposure duration, higher doses.
- In opioid-naive subgroup, risk factors were the same, but tended to be stronger.
- Protective factors: being employed, having arthritis.
- Systematic review of 65 studies patients who were prescribed the drugs for non-cancer-related pain; 43 were meta-analyzed (n=30,571,969-30,586,274).
- They assessed risk factors for opioid misuse in this population.
- Outcome: opioid misuse.
- Funding: Canadian Institutes of Health Research.
- High heterogeneity.
- Many studies had high bias risk.
- Interactions between risk factors not assessed.
- Few studies assessed provider-, system-level risk factors.