Does Report of Craving Opioid Medication Predict Aberrant Drug Behavior Among Chronic Pain Patients?

Objective: To examine the relationship between the self-report of craving prescription medication and subsequent opioid misuse among chronic pain patients prescribed opioids for pain. Methods: Six hundred thirteen (613) patients taking opioid medication for chronic noncancer pain were asked how often they have felt a craving for their medication on a scale from 0 = never to 4= very often. All subjects completed a series of baseline questionnaires. After six months the subjects were administered a structured prescription drug use interview (Prescription Drug Use Questionnaire; PDUQ), and submitted a urine sample for toxicology assessment. Their treating physicians also completed a substance misuse behavior checklist (Prescription Opioid Therapy Questionnaire; POTQ). Results: Three hundred thirty-seven subjects (55.0%) reported that they never felt a craving for their medication, while 276 (45.0%) reported some degree of craving their medication (seldom to very often). Those who reported craving their medication were significantly more often male (p<0.01), unmarried (p<0.05), had lower scores on social desirability (p<0.001), and had been prescribed opioids for a longer time (p<0.05) than those who did not report craving medication. A