Clinical Determinants of Unintended Prolonged Opioid Use

Identify incident cases of UPOU and prospectively assess their characteristics in comparison to new opioid users who do not progress to UPOU. At each site, opioid-naïve adults who receive opioid prescriptions will be enrolled. Opioid prescriptions (both written and filled) and self-reported opioid use will be followed, and those subjects progressing to UPOU will be identified in real time. Matched samples of patients who do and do not develop UPOU will be recruited for assessment of framework elements related to patient characteristics,including biochemical confirmation of opioid use, pain-related measures (including psychological variables), and medical and social histories. Using the information gathered in Aim 1, structural equation modeling will be utilized to evaluate the associations UPOU and the patient domain.

Inclusion Criteria:

• Age ≥ 18 years
• No use of opioids for 6 months prior to the issuance of the initial opioid prescription
• Willingness to participate in all aspects of the study including use of the Hugo platform on their personal smartphone

Exclusion Criteria:

• Cancer-associated pain
• Concurrent treatment for cancer (e.g., chemotherapy, radiation therapy)
• Residence in an extended care facility
• Any operation or hospitalization within the past 6 months
• Mental health disorders that could impede functioning in an ambulatory care setting (e.g., schizophrenia, dementia)
• Non-English speaking individuals
• No smartphone
• Use of a pharmacy that is not compatible with the Hugo platform.