Opioid substitution therapy among chronic pain patients dependent on opioid medications: Current utilisation, barriers and opportunities

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Date Commenced:
03/2014
Expected Date of Completion:
2016
Project Supporters:

Indivior

Drug Type:
Project Members: 
image - Briony Larance Square
Senior Lecturer
Ph 02 9385 0333
image - Headshot Nielsen 2017 1cropped 0
Senior Lecturer
Ph 02 8936 1017
image - 1314143637 Campbell Gabrielle 08
Aus Postdoc R/Fellow (NH&MRC)
Ph 02 9385 0286
Project Main Description: 

This study examines the utilisation of opioid substitution therapy among a large community sample of chronic non-cancer pain patients receiving long-term opioid substitution therapy (OST). The study will examine current levels of OST and other primary healthcare utilisation among the sample; characteristics of current treatment settings and prescribers; perceptions of opioid dependence; current medication-control strategies currently being used in their treatment;  and attitudes and barriers to OST.

Project Collaborators: External: 

A/Prof Raimondo Bruno
University of Tasmania

Prof Nicholas Lintzeris
University of Syndey; SESLHD

Prof Milton Cohen

Rationale: 

Over the past decade, there has been increasing professional and public concern in a number of countries about pharmaceutical opioid use and related harms. This has been driven by increases in prescribing of these drugs, which has been accompanied by increases in injection of some opioids by people who inject drugs regularly (PWID) and increased concern about the appropriateness of prescribing these drugs for chronic non-cancer pain (CNCP). The use of opioids outside the bounds of a doctor’s prescription has been cause for concern because of the risk of iatrogenic dependence, and serious adverse events including opioid overdose.

Aims: 
  1. To examine the prescribing of opioid substitution therapy (OST) medications in the POINT cohort, including methadone and high-dose buprenorphine;
  2. To examine the demographic characteristics, health profiles and treatment settings among opioid-dependent patients receiving OST compared to those not currently receiving OST;
  3. To examine perceptions of opioid dependence, and attitudes and barriers to OST medications, such as methadone, buprenorphine and buprenorphine-naloxone, among chronic pain patients receiving long-term opioid therapy.
Design and Method: 

A cross-sectional survey of 1,250 chronic non-cancer patients.

Progress/Update: 

Data collection has been completed and preliminary analyses have been presented at the NDARC Symposium and APSAD Conference 2015. Peer-reviewed publications are currently being prepared.

Output: 

An interim report has examined data collected from the first 750 participants. Peer-reviewed publications are being prepared examining outcomes among 1,250 participants.

Conference presentations:

Larance, B., Campbell, G., Nielsen, G., Bruno, R., Lintzeris, N., Cohen, M., Degenhardt, L. (2015) Help-seeking for opioid medication-related problems among a cohort of chronic non-cancer pain patients prescribed strong opioids. Oral presentation to the Australasian Professional Society of Alcohol and Drugs (APSAD) Conference, 9-11 November 2015. Perth, Australia.

Larance, B., Campbell, G., Nielsen, S., Bruno, R., Lintzeris, N., Cohen, M., Degenhardt, L. (2015)  Medication control and help-seeking among a cohort of people with chronic non-cancer pain who are prescribed opioids.  Oral presentation to National Drug and Alcohol Centre Annual Symposium, Sydney, 15 September 2015.

Drug Type: 
Project Status: 
Current