Methods: Chronic pain patients (N = 315) prescribed opioid analgesics for > 90 days were classified as opioid misusers (n = 186) or non-misusers (n = 128) according to a validated clinical cut-point on the Current Opioid Misuse Measure (COMM). Next, participants completed a dot probe task designed to measure opioid AB. In this cognitive task, participants are presented with pairs of opioid-related and neutral images side-by-side on a computer screen for 200 milliseconds, one of which is then replaced by a target probe. Participants press a key to indicate the location of the target probe, and reaction times are recorded. Attentional bias is evidenced by shorter reaction times to probes replacing opioid-related images relative to probes replacing neutral images. For a subsample of study participants (n = 53), baseline opioid AB was used to predict opioid misuse severity six months following psychosocial treatment.
Results: In support of our primary hypothesis, opioid misusers exhibited a significantly greater opioid AB than non-misusers, t(312) = 2.18, p = .03. Opioid AB predicted opioid misuse six months following treatment, β = .50, p = .0001, and remained a significant predictor even after controlling for baseline opioid misuse severity.
Conclusions and Implications: Findings demonstrate the presence of an opioid AB among chronic pain patients at risk for opioid misuse, and opioid AB predicted clinical outcomes six months following treatment. To our knowledge, this is the largest study to employ a cognitive task to detect risk for addictive behaviors. Social work researchers should consider using similar cognitive tasks to assess risk and protective factors in individuals with substance use disorders.