OBJECTIVES: To identify opioid abuse and misuse behaviors among chronic pain patients requiring long-term prescription opioids using the new self-report measure Prescription Opioid Misuse and Abuse Questionnaire (POMAQ) study.

METHODS: Chronic pain patients, on ≥3 months of prescription opioids, were identified through claims data from five US military hospital regions (excluding active duty patients) and invited to participate. After consent, participants completed the following web-based questionnaires: POMAQ; Brief Pain Inventory-Short Form (BPI-SF); Prescription Drug Use Questionnaire – Patient version (PDUQp); Socially Desirable Response Set Five-item Survey (SDRS-5); Medical Outcomes Study 36-item Short Form (MOS SF-36). The Structured Clinical Interview for DSM-IV-TR Axis I Disorders (SCID-I) Substance Use Disorders Module was administered after questionnaire completion to identify abuse or addiction. Participants provided urine and (optional) hair samples.

RESULTS: Of the 938 participants enrolled; 809 (86.2%) completed the POMAQ. Among completers, 55.5% were female; 74.8% White/Caucasian; mean (SD) age 55.4 (12.7) years; pain duration 14.7 (10.5) years; opioid treatment duration 11.7 (9.4) years; and 91.2% had at least one comorbidity. The most common pain conditions were low back pain (76.6%), neck/shoulder pain (60.3%), and osteoarthritis (38.7%). The most commonly prescribed current opioid medications were oxycodone (35.7%), tramadol (34.5%), and hydrocodone (26.9%) with 54.8% currently taking one opioid and 45% taking ≥2 opioids. Participants’ health status was poor on the MOS SF-36. Pain severity and interference on the BPI-SF were high and moderate, respectively. Few potential abuse/misuse behaviors were reported in the past year with most POMAQ behaviors falling in the 2–20% range; 2.6% met the PDUQp criteria for substance use disorder; 0.6% met SCID-I criteria for opioid abuse or dependence.

CONCLUSIONS: Patients with long-term chronic pain taking opioids have multiple comorbidities and experience significant burden on patient-reported health status measures. However, they report few behaviors indicative of potential misuse or abuse of opioids.