{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:48:00Z","timestamp":1791546480741,"version":"4.3.4"},"reference-count":207,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T00:00:00Z","timestamp":1722988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["PDF\u20102017\u201010\u2010068"],"award-info":[{"award-number":["PDF\u20102017\u201010\u2010068"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003921","name":"Department of Health and Aged Care, Australian Government","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003921","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Chronic non\u2010cancer pain (CNCP) is one of the most common causes of disability globally. Opioid prescribing to treat CNCP remains widespread, despite limited evidence of long\u2010term clinical benefit and evidence of harm such as problematic pharmaceutical opioid use (POU) and overdose. The study aimed to measure the prevalence of POU in CNCP patients treated with opioid analgesics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      A comprehensive systematic literature review and meta\u2010analysis was undertaken using MEDLINE, Embase and PsycINFO databases from inception to 27\u2009January 2021. We included studies from all settings with participants aged \u2265\u200912 with non\u2010cancer pain of \u2265\u20093\u00a0months duration, treated with opioid analgesics. We excluded case\u2013control studies, as they cannot be used to generate prevalence estimates. POU was defined using four categories: dependence and opioid use disorder (D&amp;OUD), signs and symptoms of D&amp;OUD (S&amp;S), aberrant behaviour (AB) and at risk of D&amp;OUD. We used a random\u2010effects multi\u2010level meta\u2010analytical model. We evaluated inconsistency using the\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      statistic and explored heterogeneity using subgroup analyses and meta\u2010regressions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 148 studies were included with &gt;\u20094.3 million participants; 1% of studies were classified as high risk of bias. The pooled prevalence was 9.3% [95% confidence interval (CI)\u2009=\u20095.7\u201314.8%;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u200999.9%] for D&amp;OUD, 29.6% (95% CI\u2009=\u200922.1\u201338.3%,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u200999.3%) for S&amp;S and 22% (95% CI\u2009=\u200917.4\u201327.3%,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u200999.8%) for AB. The prevalence of those at risk of D&amp;OUD was 12.4% (95% CI\u2009=\u20094.3\u201330.7%,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200999.6%). Prevalence was affected by study setting, study design and diagnostic tool. Due to the high heterogeneity, the findings should be interpreted with caution.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Problematic pharmaceutical opioid use appears to be common in chronic pain patients treated with opioid analgesics,\u00a0with nearly one in 10 experiencing dependence and opioid use disorder, one in three showing signs and symptoms of dependence and opioid use disorder and one in five showing aberrant behaviour.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.16616","type":"journal-article","created":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T19:10:42Z","timestamp":1723057842000},"page":"1904-1922","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Prevalence of problematic pharmaceutical opioid use in patients with chronic non\u2010cancer pain: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5418-4034","authenticated-orcid":false,"given":"Kyla H.","family":"Thomas","sequence":"first","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol  Canynge Hall Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6687-5374","authenticated-orcid":false,"given":"Michael N.","family":"Dalili","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol  Canynge Hall Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung\u2010Yuan","family":"Cheng","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol  Canynge Hall Bristol UK"},{"name":"Translational Health Sciences, Bristol Medical School University of Bristol  Musculoskeletal Research Unit, Learning and Research Building, Southmead Hospital Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Dawson","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol  Canynge Hall Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Donnelly","sequence":"additional","affiliation":[{"name":"Population HealthSciences, Bristol Medical School University of Bristol  Oakfield House,Oakfield Grove Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8323-2514","authenticated-orcid":false,"given":"Julian P. 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