Clinical and Mental Health Characteristics Among Patients Receiving Medications for OUD Treatment vs High-Dose Opioids When Referred for Pain Management.

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 to those taking prescription opioid analgesics in oral morphine equivalent daily doses at low (<40 mg) and high doses (>100 mg) using 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 = 1,016) and high-dose opioids (n = 7,122) were similar in that they both had more severe mental health symptoms and longer pain duration, compared with the low-dose group (n = 20,517). Compared to 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 catastrophising 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.