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Eligible participants included adults &gt;\u200918\u2009years old, not undergoing cancer treatment, had pain &gt;\u20093\u2009months, and had been referred to a specialised pain care centre in Sweden. Bivariate logistic regression and multivariable logistic regression with forward selection were used to examine the associations between biopsychosocial variables and either long\u2010term opioid use or P\u2010OUD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 339 patients included, 194 (57%) were using opioids, 159 (47%) had long\u2010term opioid use (&gt;\u200990\u2009days), and 34 (21% of those with long\u2010term opioid use) had P\u2010OUD. Longer pain duration, unemployment, more pain catastrophising, lower health\u2010related quality of life, and worse balance increased the likelihood of long\u2010term opioid use. Long\u2010term use of high doses was associated with a greater prevalence of psychiatric and cognitive\u2010behavioural problems compared to long\u2010term use at low to moderate doses. Long\u2010term opioid use, younger age, trauma exposure, more pain catastrophising, and fear of movement increased the likelihood of P\u2010OUD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results demonstrate the importance of identifying and treating salient factors that may sustain both the pain condition and long\u2010term opioid use. Many of the biopsychosocial variables associated with long\u2010term opioid use and P\u2010OUD can be addressed within interdisciplinary pain management and rehabilitation programmes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>This study is part of the U\u2010PAIN cohort study on a clinical sample from a highly specialised pain centre in Sweden. It is based on a deep and thorough characterisation of patients referred to the clinic to evaluate risks and benefits of opioid therapy in chronic pain. It adds valuable information on the complexity of opioid therapy in chronic pain; the results highlight the need for interdisciplinary multimodal evaluation and treatment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.70081","type":"journal-article","created":{"date-parts":[[2025,7,19]],"date-time":"2025-07-19T08:19:34Z","timestamp":1752913174000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Opioid Use and Prescription Opioid Use Disorder: Biopsychosocial Characterisation of a Clinical Chronic Pain Cohort"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1196-7810","authenticated-orcid":false,"given":"Sofia","family":"Wagner","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"},{"name":"Uppsala University Hospital  Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3655-6524","authenticated-orcid":false,"given":"Hanna","family":"Ljungvall","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4219-5075","authenticated-orcid":false,"given":"Hedvig","family":"Zetterberg","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3923-4093","authenticated-orcid":false,"given":"Rolf","family":"Karlsten","sequence":"additional","affiliation":[{"name":"Uppsala University Hospital  Uppsala Sweden"},{"name":"Department of Surgical Sciences Uppsala University  Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5760-7730","authenticated-orcid":false,"given":"Lisa","family":"Ekselius","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Upsala University, WOMHER  Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7999-6087","authenticated-orcid":false,"given":"Pernilla","family":"\u00c5senl\u00f6f","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"},{"name":"Uppsala University Hospital  Uppsala Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1515\/sjpain\u20102020\u20100187"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/09593985.2019.1570577"},{"key":"e_1_2_9_4_1","volume-title":"Diagnostic and Statistical Manual of Mental Disorders: DSM\u2010IV","author":"American Psychiatric Association","year":"1994"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13181\u2010012\u20100257\u20108"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001680"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1389\u20109457(00)00065\u20104"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/alcalc\/37.3.245"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001401"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/314184"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2020.100592"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsa.2004.65.774"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2021.02.003"},{"key":"e_1_2_9_15_1","first-page":"129","article-title":"Pain Assessment: Global Use of the Brief Pain Inventory","volume":"23","author":"Cleeland C. 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