Opioid prescribing habits and effectiveness within subgroups of chronic low back pain patients

PURPOSE: This study aims to describe prescription opioid usage among chronic low back pain patients and report the percent compliance with Centers for Disease Control and Prevention guidelines. Additionally, this study seeks to correlate the amount of opioid use with pain intensity and the likelihood of experiencing adverse effects in participants of different race and to determine whether admixture, the estimate of an individual's genetic contribution from different ancestral backgrounds, plays a role in determining the effect of opioids on pain-related measures. METHODS: Medication list and pain measures were collected from participants enrolled in Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation (PRECISION). Saliva samples were obtained to determine participants' admixture scores. Opioid usage was characterized based on morphine milligram equivalents (MME) to calculate mean daily MME. Mean MME was also calculated based on race and was correlated to pain scores and adverse events, collected from questionnaires. Admixture analysis was performed to generate k score. RESULTS: Mean MME prescribed to 164 registry participants was 36.14. Results showed that 78% of participants consumed under 50 MME, 15% of participants consumed between 50 and 90 MME, and 7% of participants consumed >90 MME. Admixture analysis showed a correlation between degree of admixture and reported adverse events and pain scores. CONCLUSION: The majority of participants were prescribed opioids in compliance with CDC recommendations. However, 7% of the participants were prescribed high doses outside recommended limits, which is greater than previous estimates. Admixture may play a role in optimizing opioid metabolism.