Journal of Substance Abuse Treatment
Volume 33, Issue 3 , Pages 303-311, October 2007

Addiction Severity Index in a chronic pain sample receiving opioid therapy

  • Kenneth Saffier, M.D.

      Affiliations

    • Department of Family and Community Medicine, University of California Davis and Contra Costa Regional Medical Center, Martinez, CA 94552, USA
    • ,
  • Cynthia Colombo, M.S.

      Affiliations

    • Department of Family Medicine, University of Wisconsin, Madison, WI 53715, USA
    • ,
  • David Brown, Ph.D.

      Affiliations

    • British Columbia Provincial Health Services, Vancouver, BC, Canada V57 4C2
    • ,
  • Marlon P. Mundt, M.S.

      Affiliations

    • Department of Family Medicine, University of Wisconsin, Madison, WI 53715, USA
    • ,
  • Michael F. Fleming, M.D., M.P.H.

      Affiliations

    • Department of Family Medicine, University of Wisconsin, Madison, WI 53715, USA
    • Corresponding Author InformationCorresponding author. Department of Family Medicine, University of Wisconsin, Madison, WI 53715, USA. Tel.: +1 608 263 9953; fax: +1 608 263 5813.

Received 6 September 2006; received in revised form 13 December 2006; accepted 25 December 2006. published online 22 March 2007.

Abstract 

The treatment of chronic pain with opioids remains controversial. Physicians are concerned about addiction and drug diversion, and there is limited empirical information on the use of opioids in patients with chronic pain. This report presents data on the Addiction Severity Index (ASI) collected in a sample of patients (N = 908) receiving opioids from their primary care physicians. The ASI provides clinically important information about patients receiving opioid therapy. The ASI consists of seven subscales, including medical, alcohol, drug, employment/support, legal, family/social, and psychiatric domains. Clinically relevant findings include high ASI medical score (0.87), high psychiatric severity score (0.27), lifetime treatment of alcohol problems (reported by 22% of men), prior delirium tremens (5.6%), prior treatment for drug problems (10.1%), prior drug overdose (12.1%), and drunk-driving citations (28%); 40.3% of women had serious suicidal thoughts, and 23.8% had suicide attempts. The ASI provides important information that can help primary care physicians manage patients with chronic pain who are receiving opioid therapy.

Keywords: Addiction Severity Index, ASI, Chronic opioid therapy, Chronic pain, Primary care, Substance use disorders

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PII: S0740-5472(07)00005-0

doi:10.1016/j.jsat.2006.12.011

Journal of Substance Abuse Treatment
Volume 33, Issue 3 , Pages 303-311, October 2007

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