Unintended Prolonged Opioid Use: An Under-Recognized Segue to Long-Term Use (310)

3:30–4:30 pm Saturday, April 28

With rare exceptions, practitioners do not intend for an initial opioid prescription given for an acute pain episode to result in indefinite repeat prescriptions; a phenomenon termed unintended prolonged opioid use (UPOU). Recently, intentional short-term use has emerged as a previously under-recognized segue to long-term use. This session provides an expanded awareness of the complex determinants, allowing clinicians the ability to better understand and mitigate UPOU.

Epidemiology, Patient Factors, and Regulatory Influences

W. Michael Hooten, MD

The Role of Patient Self-Selection

Mark Sullivan, MD PhD

Negative Affect and the Mediating Role of Opioid Craving

Ajay D. Wasan, MD MSc

Learning Objectives:

  • Demonstrate how key patient characteristics could potentially influence unintended prolonged opioid use including, (1) medical and mental health conditions; (2) the etiology of pain; (3) individual affective, behavioral, and neurophysiological responses to pain and opioids; and 4) sociodemographic factors.
  • Demonstrate how individual practitioner characteristics could influence prescribing behaviors including, (1) medical or surgical specialty and training in pain medicine; (2) personal attitudes, knowledge, and beliefs regarding the risks and benefits of opioids; and (3) perceived professional norms.
  • Demonstrate how unintended prolonged opioid use could be influenced by the practice and regulatory environments.