Opioid Expectations - developing a questionnaire for assessing beliefs and expectations about effects of opioid analgesics

A little over ten percent of the Norwegian population was prescribed at least one opioid as an outpatient in 2016 (Muller et al., 2019). Years later, many of the people initially treated with opioids develop long-term use, which is associated with increased risk of misuse and addiction. Of the patients that had a prescription in 2007, fifty percent still had a prescription in 2017 (Skurtveit et al., 2020). Diverse risks such as mental health disorders, history of childhood trauma, various pain indices and demographic factors are associated with increased probability for opioid misuse and dependence (Pergolizzi et al., 2012). The risk factors for prescription opioid misuse have typically been identified largely through correlational studies using epidemiological and retrospective insurance claim data (e.g. Cochran et al., 2014). The psychological mechanisms predicting opioid use and misuse remain largely unknown, despite being much more suitable for intervention than risk

factors such as chronic pain, previous drug use disorder or early life trauma. We propose to determine the predictive role of attitudes and decision making for opioid use and misuse, such as (1) Expectations about the effects of the drug (2) Attitudes towards opioids and use of drugs in general (3) Knowledge about risks of using opioids.

Currently there is no available tool for assessing opioid-related beliefs and expectations in individuals without a history of prolonged opioid use or opioid dependence. In this project we will develop a questionnaire suitable for use across opioid naïve individuals and those with a history of opioid use or misuse. Norwegian and English versions of the scale will be developed, based on a combination of expert knowledge and pilot data. We aim to make a short, open-access scale that can be a useful tool in diverse settings such as in experimental psychopharmacology research and clinical trials on substance use treatment and by physicians in pain clinics.