Biopsychosocial (BPS) complexity and opioids

This study explores the relationship between biopsychosocial (BPS) complexity and opioid prescription in patients with chronic musculoskeletal pain. The study included 3,923 individuals from a tertiary care rehabilitation clinic and aimed to assess the direct and indirect effects of BPS complexity and pain-related factors on opioid prescription. Using structural equation modeling, the study found that BPS complexity had a direct effect on both the likelihood of opioid prescription and the daily morphine equivalent dose (dMED). Indirect effects were observed through pain severity and depressive symptoms. Pain catastrophizing was also indirectly associated with opioid prescription and dose via pain severity. The likelihood of opioid prescription was higher among females, those with increased education levels, and those with spine trauma, with the latter two factors also associated with higher dMED. The study concludes that addressing patients' BPS complexity could help reduce opioid prescriptions and the risk of misuse. Key factors include pain severity, depressive symptoms, and sociodemographic variables.