Back Pain Sufferers and Patients on Opioid Therapy at Elevated Risk for Illicit Drug Use

A study conducted by researchers from the University of Minnesota concludes that people suffering from chronic low back pain (cLBP) are more likely than nonsufferers to be users of illicit drugs including marijuana, cocaine, heroin, and methamphetamine. The association may affect prescribers’ decisions about opioid therapy for these patients, according to the authors. Opioids are widely prescribed for patients with cLBP, and previous studies have found that people with a history of illicit drug use are more likely to misuse prescription opioids. The study is one of the first to focus on rates of illicit drug use among Americans with cLBP. The findings are published in the journal Spine.

The research considered 5,000 adults aged 20 to 69 from the 2009 to 2010 National Health and Nutrition Examination Survey. 13% of these met the study definition of cLPB which was back pain present for at least 3 months. All were asked by confidential survey about their use of marijuana, cocaine, heroin, and methamphetamine. The study found that all 4 substances were more commonly used by the cLPB patient cohort, with more than 2x likelihood for use of heroin or methamphetamine. In addition, patients who used the illicit drugs were more likely to also have a current prescription for opioids. Study author Anna Shmagel, MD, commented, "As we face a prescription opioid addiction epidemic, careful assessment of illicit drug use history may aid prescribing decisions."

A news story about the findings, with link to the journal article may be read here.

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