Clinical and mental health characteristics among patients receiving medications for opioid use disorder treatment versus patients receiving low- and high-dose opioids when referred for pain management

Abstract Objective To examine the demographic and clinical characteristics of patients attending pain management services who were receiving opioid agonist treatment (ie, methadone or buprenorphine for the treatment of opioid use disorder) in comparison with those taking prescription opioid analgesics in oral morphine equivalent daily doses at low (<40 mg) and high doses (>100 mg) in a national database from the electronic Persistent Pain Outcomes Collaboration (ePPOC) in Australia. Design A cross-sectional study. Setting Australian pain services. Subjects Adult patients referred to Australian pain service clinics between 2016 and 2021. Methods Multinomial and bivariate logistic regression models were conducted to compare the demographic and clinical characteristics of patients on opioid agonist treatment and those taking other prescription opioid analgesics. Results Among 42 182 participants, most were female (56.8%), with a mean age of 51.7 years. People on opioid agonist treatment (n = 1016) and high-dose opioids (n = 7122) were similar in that they both had more severe mental health symptoms and longer pain duration than the low-dose group (n = 20 517). Compared with the high-dose group, people on opioid agonist treatment had reduced odds of reporting more severe pain intensity but increased odds of having multimorbidity, more severe anxiety, and pain catastrophizing thoughts. Conclusions These findings highlight the need for mental health treatment and the necessity of tailored multidisciplinary pain management for people in opioid agonist treatment.