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Pain Research and Treatment
Volume 2012, Article ID 167062, 7 pages
http://dx.doi.org/10.1155/2012/167062
Research Article

Attitudinal Barriers to Analgesic Use among Patients with Substance Use Disorders

1Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center and Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA
2Department of Medicine, Cambridge Health Alliance, Cambridge, MA 02139, USA
3Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA
4Department of Community Health Sciences, Boston University School of Public Health, Boston, MA 02118, USA
5Data Coordinating Center, Boston University School of Public Health, Boston, MA 02118, USA

Received 14 November 2011; Revised 29 February 2012; Accepted 2 March 2012

Academic Editor: Howard Smith

Copyright © 2012 Leah Zallman et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Attitudinal barriers towards analgesic use among primary care patients with chronic pain and substance use disorders (SUDs) are not well understood. We evaluated the prevalence of moderate to significant attitudinal barriers to analgesic use among 597 primary care patients with chronic pain and current analgesic use with 3 subscales from the Barriers Questionaire II: concern about side effects, fear of addiction, and worry about reporting pain to physicians. Concern about side effects was a greater barrier for those with opioid use disorders (OUDs) and non-opioid SUDs than for those with no SUD (OR (95% CI): 2.30 (1.44–3.68), and 1.64 (1.02–2.65), , resp.). Fear of addiction was a greater barrier for those with OUDs as compared to those with non-opioid SUDs (OR (95% CI): 2.12 (1.04–4.30), ) and no SUD (OR (95% CI): 2.69 (1.44–5.03), ). Conversely, participants with non-opioid SUDs reported lower levels of worry about reporting pain to physicians than those with no SUD (OR (95% CI): 0.43 (0.24–0.76), ). Participants with OUDs reported higher levels of worry about reporting pain than those with non-opioid SUDs (OR (95% CI): 1.91 (1.01–3.60), ). Concerns about side effects and fear of addiction can be barriers to analgesic use, moreso for people with SUDs and OUDs.