Opioids and the treatment of chronic pain in a primary care sample

Chronic pain is a widespread, difficult problem facing clinicians. This study assessed the current medical management of a general Population of patients with chronic pain in 12 family medicine practices located throughout the state of Wisconsin. Medical record audits were conducted on a sample of 209 adults. Sixty-seven percent were female with an average age of 53 years. The most common pain diagnoses included lumbar/low back (44%), joint disease/arthritis (33%), and headache/migraine (28%) pain. The most frequently prescribed opioids were oxycodone/acetaminophen (31%), morphine ERT (19%), Tylenol #3 (15%), and hydrocodone/acetaminophen (14%). Depression/affective disorders were reported in 36% of the patient charts, anxiety/panic disorders (15%), drug abuse (6%), and alcohol abuse (3%). Written drug contracts were utilized by 42% (n = 31) of the practitioners, pain scales 25% (n = 29), and urine toxicology screens 8%(n = 6). This study suggests that primary care practitioners have unique opportunities to identify and successfully treat patients with chronic pain. (C) U.S. Cancer Pain Relief Committee, 2001.