Every day, 46 people die from overdoses involving prescription opioids in the United States. Increased oversight of physician prescribing practices, especially for long-term management of chronic noncancer pain, has helped curb overprescribing. However, some advocates fear that patients who need and use prescription opioids as prescribed for chronic pain may be kept from accessing medications that improve their quality of life.
Musculoskeletal conditions such as arthritis are the leading cause of disability and chronic pain in the United States. About 54.4 million U.S. adults live with arthritis, with 8.4 million reporting their condition as disabling. Historically, clinicians have prescribed opioids to people experiencing severe and chronic arthritis pain with the goal of improving physical function, participation in daily activities, and quality of life. Although opioids can control acute pain effectively, there is insufficient evidence about the effectiveness of long-term use of opioids to control chronic pain among people with and without disabilities, and whether the potential risks, including developing an OUD, outweigh the benefits.
Through a National Institute on Disability, Independent Living, and Rehabilitation Research grant, AIR is laying the groundwork for primary care clinicians and specialists to accurately assess for OUD in people with disabilities who are taking opioids long term to manage musculoskeletal pain. The objective is to use the best available evidence to help clinicians minimize over- and under-diagnosis of OUD. The project includes:
- Conducting a systematic literature review to identify evidence-based best OUD assessment practices, tools, and resources;
- Identifying barriers and facilitators to OUD assessment and treatment access through qualitative research;
- Adapting and testing a screening tool to detect OUD in people taking opioids long term to manage musculoskeletal pain; and
- Developing and disseminating an OUD assessment and referral toolkit through provider and disability organizations and those training providers in addiction medicine.