PT - JOURNAL ARTICLE AU - Robert Andrew Gardner AU - Kori L Brewer AU - Dennis B Langston TI - Predicting opioid use disorder in patients with chronic pain who present to the emergency department AID - 10.1136/injuryprev-2018-042723 DP - 2018 Apr 06 TA - Injury Prevention PG - injuryprev-2018-042723 4099 - http://injuryprevention.bmj.com/content/early/2018/04/06/injuryprev-2018-042723.short 4100 - http://injuryprevention.bmj.com/content/early/2018/04/06/injuryprev-2018-042723.full AB - Background Emergency department (ED) patients with chronic pain challenge providers to make quick and accurate assessments without an in-depth pain management consultation. Emergency physicians need reliable means to determine which patients may receive opioid therapy without exacerbating opioid use disorder (OUD).Methods Eighty-nine ED patients with a chief complaint of chronic pain were enrolled. Researchers administered questionnaires and reviewed medical and state prescription monitoring database information. Participants were classified as either OUD or non-OUD. Statistical analysis included a bivariate analysis comparing differences between groups and multivariate logistic regression evaluating ORs.Results The 45 participants categorised as OUD had a higher proportion of documented or reported psychiatric diagnoses (p=0.049), preference of opioid treatment (p=0.005), current oxycodone prescription (p=0.043), borrowed pain medicine (p=0.004) and non-authorised dose increase (p<0.001). The state prescription monitoring database revealed the OUD group to have an increased number of opioid prescriptions (p=0.005) and pills (p=0.010). Participants who borrowed pain medicine and engaged in non-authorised dose increase were 5.2 (p=0.025, 95% CI 1.24 to 21.9) and 6.1 times (p=0.001, 95% CI 1.55 to 24.1) more likely to have OUD, respectively.Limitations Major limitations of our study include a small sample size, self-reported measures and convenience sample which may introduce selection bias.Conclusion Patients with chronic pain with OUD have distinguishable characteristics. Emergency physicians should consider such evidence-based variables prior to opioid therapy to ameliorate the opioid crisis and limit implicit bias.