# Factors Associated with Initiation of Opioid Use in a US Department of Veterans Affairs Pain Clinic: A Retrospective Study

## TL;DR

This study examines factors linked to starting opioid prescriptions for veterans with chronic pain at a US VA clinic.

## Contribution

The study identifies employment and substance use history as factors influencing opioid initiation in veterans with chronic pain.

## Key findings

- 19% of veterans received a new opioid prescription within a year of their pain clinic visit.
- A history of substance use was linked to lower odds of receiving an opioid prescription.
- Being employed was associated with higher odds of receiving an opioid prescription.

## Abstract

Background: Guidelines suggest that, in chronic non-cancer pain (CNCP) management, non-opioid modalities should be prioritized, as there are negative consequences related to opioid use. There is a dearth of literature elucidating the risk factors for initiating opioid use amongst veterans with CNCP. Methods: Chart review on 193 patients with a new referral at a local US Department of Veterans Affairs (VA) pain clinic. Patients were required to have CNCP and not be taking opioid medication at the time of referral. The review started on 1 January 2014 and covered the year following. Data were analyzed via stepwise multiple logistic regression using Statistical Analysis System (SAS) software (Version 9.4; SAS institute Inc., Cary, NC, USA). Results: A total of 37 veterans (19%) received a new opioid prescription in the year following initial encounters at the pain clinic for CNCP. A history of substance use was associated with lower odds of receiving an opioid prescription. In contrast, being employed was associated with higher odds of receiving an opioid prescription. Conclusions: Amongst veterans treated for CNCP in a VA pain clinic, a history of substance use and a presence of vocation within the past year prior to presentation are variables associated with the initiation of opioids. Future studies to further elucidate the predictors of opioid prescriptions for CNCP are warranted.