{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T05:18:10Z","timestamp":1754111890978,"version":"3.37.3"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,12,4]],"date-time":"2018-12-04T00:00:00Z","timestamp":1543881600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008460","name":"National Center for Complementary and Integrative Health","doi-asserted-by":"publisher","award":["UG3AT009790"],"award-info":[{"award-number":["UG3AT009790"]}],"id":[{"id":"10.13039\/100008460","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Recent clinical practice guidelines have suggested conservative treatment approaches, including physical therapy, are indicated as first\u2010line treatment for patients with low back pain (<jats:styled-content style=\"fixed-case\">LBP<\/jats:styled-content>); however, <jats:styled-content style=\"fixed-case\">LBP<\/jats:styled-content> continues to be managed with opioids, despite decreases in function, morbidity, and insignificant improvements in pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The primary purpose was to compare characteristics and downstream medication use between patients with <jats:styled-content style=\"fixed-case\">LBP<\/jats:styled-content> with prior opioid exposure vs. those who were opioid\u2010na\u00efve. The secondary purpose was to explore the role of prior opioid use by <jats:styled-content style=\"fixed-case\">LBP<\/jats:styled-content> disability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seven hundred and nine participants in a <jats:styled-content style=\"fixed-case\">LBP<\/jats:styled-content> self\u2010management class were evaluated utilizing self\u2010report data at baseline and longitudinal claims data from the Military Health System Data Repository. Participants were dichotomized into opioid\u2010na\u00efve and prior opioid use groups and then further divided into low and high disability groups based on Oswestry Disability Index (<jats:styled-content style=\"fixed-case\">ODI<\/jats:styled-content>) scores. Patient characteristics, comorbidities, and medication use were compared between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Prior opioid users had significantly higher baseline <jats:styled-content style=\"fixed-case\">ODI<\/jats:styled-content> and Fear Avoidance Beliefs Questionnaire physical activity subscale and work subscale scores as well as pre\u2010index instances of mental health disorders, chronic pain, and insomnia than opioid\u2010na\u00efve individuals. Prior opioid users filled significantly more pain medication prescriptions in the year after the index date than did opioid\u2010na\u00efve individuals. Prior opioid users were significantly more likely to be taking opioids at 1\u00a0year after the index date, regardless of disability level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients presenting with <jats:styled-content style=\"fixed-case\">LBP<\/jats:styled-content>, prior opioid exposure appears to be related to increased analgesic use (opioid and non\u2010opioid) and longitudinal analgesic utilization at 1\u00a0year after the index date.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.12728","type":"journal-article","created":{"date-parts":[[2018,9,30]],"date-time":"2018-09-30T12:49:03Z","timestamp":1538311743000},"page":"149-157","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Differences in Characteristics and Downstream Drug Use Among Opioid\u2010Na\u00efve and Prior Opioid Users with Low Back Pain"],"prefix":"10.1111","volume":"19","author":[{"given":"Lindsay 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