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Addiction
Research
Opioid use disorder in chronic non-cancer pain in Germany: a cross sectional study
  1. Johannes Maximilian Just1,
  2. Fabian Schwerbrock1,
  3. Markus Bleckwenn1,
  4. Rieke Schnakenberg2,
  5. Klaus Weckbecker1
  1. 1 Institute of General Practice and Family Medicine, Universitatsklinikum Bonn, Bonn, Germany
  2. 2 Department für Versorgungsforschung, Carl von Ossietzky University Oldenburg, Oldenburg, UK
  1. Correspondence to Dr Johannes Maximilian Just; johannes.just{at}ukbonn.de

Abstract

Objectives The DSM-5 diagnosis ‘opioid use disorder’ (OUD) was established to better describe and detect significant impairment or distress related to opioid use. There is no data on rates of OUD in chronic non-cancer pain (CNCP) in European countries. Therefore, our objective was to screen patients in specialised pain centres for signs of OUD.

Design Cross-sectional questionnaire study.

Setting Four outpatient pain clinics in the area of Bonn, Germany.

Participants n=204 patients participated in the study (response rate: 87.9%). All adult patients with opioid pain therapy >6 months for CNCP were included. Excluded were patients with malignant disease, patients who could not collect their prescription themselves due to age or multimorbidity and patients on opioid-maintenance therapy.

Primary and secondary outcome measure Primary outcome measure was the proportion of patients with mild to severe OUD.

Results One-fourth (26.5%) of participants were diagnosed with OUD. Moderate to severe disorder was found in 9.3. Young age was the only connected risk factor (OR 0.96 [95% CI 0.94 to 0.99], p: 0.003).

Conclusions OUD is a relevant diagnosis in patients on long-term opioid therapy for CNCP in the Bonn area. Careful follow-up by the attending physicians is advisable, especially in patients with moderate or severe disorder.

  • opioid use disorder
  • prescription opioids
  • prevalence

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-026871

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    Footnotes

    • Contributors JMJ designed the study with FS and drafted main parts of the paper. FS gathered data, performed statistical analysis and contributed to the development of the paper. MB contributed to the development of the paper. RS gave support in statistical analysis and helped drafting the paper. KW had the initial idea and helped drafting the final paper. All authors read and approved the final manuscript. All authors discussed the results and approved the final version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Ethics approval The study was carried outunder the Declaration of Helsinki. It received ethical approvalby the Ethics Committee of the Medical Faculty of the University of Bonn (No. 091/17).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement All data used is available through the authors upon request.

    • Patient consent for publication Not required.