TY - JOUR
T1 - Characterizing opioid use in a US population with migraine
T2 - Results from the CaMEO study
AU - Lipton, Richard B.
AU - Buse, Dawn C.
AU - Friedman, Benjamin W.
AU - Feder, Lisa
AU - Adams, Aubrey Manack
AU - Fanning, Kristina M.
AU - Reed, Michael L.
AU - Schwedt, Todd J.
N1 - Funding Information:
Writing and editorial assistance was provided to the authors by Peloton Advantage, LLC, an OPEN Health company, Parsippany, NJ, and was funded by Allergan plc. The opinions expressed in this article are those of the authors. The authors received no honorarium/fee or other form of financial support related to the development of this article. Valerie Marske of Vedanta Research worked with authors to develop the assessment tools and to manage respondent recruiting and data collection.
Funding Information:
R.B. Lipton is the Edwin S. Lowe Professor of Neurology at the Albert Einstein College of Medicine in New York. He receives research support from the NIH: 2PO1 AG003949 (mPI), 5U10 NS077308 (PI), RO1 NS082432 (investigator), 1RF1 AG057531 (site PI), RF1 AG054548 (investigator), 1RO1 AG048642 (investigator), R56 AG057548 (investigator), K23 NS09610 (mentor), K23AG049466 (mentor), and K23 NS107643 (mentor). He also receives support from the Migraine Research Foundation and the National Headache Foundation. He serves on the editorial board of Neurology® and is senior advisor to Headache and associate editor for Cephalalgia. He has reviewed for the NIA and NINDS; holds stock options in eNeura Therapeutics and Biohaven Holdings; serves as consultant, advisory board member, or has received honoraria from American Academy of Neurology, Alder, Allergan, American Headache Society, Amgen, Autonomic Technologies, Avanir, Biohaven, Biovision, Boston Scientific, Dr. Reddy's, Electrocore, Eli Lilly, eNeura Therapeutics, GlaxoSmithKline, Merck, Pernix, Pfizer, Teva, Trigemina, Vector, and Vedanta. He receives royalties from Wolff's Headache, 7th and 8th edition (Oxford Press University, 2009), Wiley, and Informa. D.C. Buse has received grant support and honoraria from Allergan, Avanir, Amgen, Biohaven, Eli Lilly and Company, and Promius and for work on the editorial board of Current Pain and Headache Reports. She was not compensated for writing or presenting any abstracts, posters, platforms, manuscripts, editorials, or other scientific communications. B.W. Friedman reports no disclosures relevant to the manuscript. L. Feder is an employee of Peloton Advantage, LLC, an OPEN Health company. A. Manack Adams is an employee of Allergan plc. K.M. Fanning is an employee of Vedanta Research, which has received research funding from Allergan, Amgen, Dr. Reddy's Laboratories, Eli Lilly, GlaxoSmithKline, Merck & Co., Inc., and Novartis, via grants to the National Headache Foundation. Vedanta has received funding directly from Allergan for work on the CaMEO study. M.L. Reed is Managing Director of Vedanta Research, which has received research funding from Allergan, Amgen, Eli Lilly, GlaxoSmithKline, Merck & Co., Inc., and Promius, and grants from the National Headache Foundation. Vedanta Research has received funding directly from Allergan for work on the CaMEO study. T.J. Schwedt has served as a consultant for Alder, Allergan, Amgen, ATI, Aural Analytics, Avanir, Cipla, Dr. Reddy's Laboratories, Eli Lilly, Ipsen Bioscience, Nocira, Novartis, Promius Pharma, Second Opinion, Teva, and Xoc. He holds stock options in Aural Analytics, Nocira, and Second Opinion and has received research funding from Amgen. Go to Neurology.org/N for full disclosures.
Publisher Copyright:
Copyright © 2020 American Academy of Neurology.
PY - 2020/8/4
Y1 - 2020/8/4
N2 - Objective To determine the prevalence of and risk factors associated with opioid use in the treatment of migraine, we examined demographics and clinical characteristics of 867 individuals who reported using opioids for the treatment of migraine.MethodsWe analyzed data from the CaMEO study (Chronic Migraine Epidemiology and Outcomes), a cross-sectional, longitudinal, Internet study, to compare sociodemographics, clinical characteristics, and migraine burden/disability of opioid users vs nonusers. Covariates were entered as categorical or continuous variables. Factors associated with opioid use were identified using nested, multivariable binary logistic regression models.ResultsOf 2,388 respondents with migraine using prescription medications for acute treatment, 36.3% reported that they currently used or kept on hand opioid medications to treat headaches. Current opioid users had significantly more comorbidities, greater headache-related burden, and poorer quality of life than nonusers. Regression models revealed factors significantly associated with opioid use, including male sex, body mass index, allodynia, increasing monthly headache frequency, Total Pain Index score (excluding head, face, neck/shoulder), anxiety, depression, ≥1 cardiovascular comorbidity, and emergency department/urgent care use for headache in the past 6 months. Self-reported physician-diagnosed migraine/chronic migraine was associated with significantly decreased likelihood of opioid use.ConclusionsOf respondents who were using acute prescription medications for migraine, more than one-third used or kept opioids on hand, contrary to guidance. This analysis could not distinguish risk factors from consequences of opioid use; thus further research is needed to guide the development of strategies for reducing the inappropriate use of opioids in migraine.
AB - Objective To determine the prevalence of and risk factors associated with opioid use in the treatment of migraine, we examined demographics and clinical characteristics of 867 individuals who reported using opioids for the treatment of migraine.MethodsWe analyzed data from the CaMEO study (Chronic Migraine Epidemiology and Outcomes), a cross-sectional, longitudinal, Internet study, to compare sociodemographics, clinical characteristics, and migraine burden/disability of opioid users vs nonusers. Covariates were entered as categorical or continuous variables. Factors associated with opioid use were identified using nested, multivariable binary logistic regression models.ResultsOf 2,388 respondents with migraine using prescription medications for acute treatment, 36.3% reported that they currently used or kept on hand opioid medications to treat headaches. Current opioid users had significantly more comorbidities, greater headache-related burden, and poorer quality of life than nonusers. Regression models revealed factors significantly associated with opioid use, including male sex, body mass index, allodynia, increasing monthly headache frequency, Total Pain Index score (excluding head, face, neck/shoulder), anxiety, depression, ≥1 cardiovascular comorbidity, and emergency department/urgent care use for headache in the past 6 months. Self-reported physician-diagnosed migraine/chronic migraine was associated with significantly decreased likelihood of opioid use.ConclusionsOf respondents who were using acute prescription medications for migraine, more than one-third used or kept opioids on hand, contrary to guidance. This analysis could not distinguish risk factors from consequences of opioid use; thus further research is needed to guide the development of strategies for reducing the inappropriate use of opioids in migraine.
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U2 - 10.1212/WNL.0000000000009324
DO - 10.1212/WNL.0000000000009324
M3 - Article
C2 - 32527971
AN - SCOPUS:85089124789
VL - 95
SP - E457-E468
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 5
ER -