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Abstract Details

Demographics, Headache Characteristics, and Other Factors Associated With Opioid Use in People With Migraine: Results From the CaMEO Study
Headache
S59 - Migraine: Impact, Treatment Patterns and Resource Utilization (1:55 PM-2:06 PM)
006
Opioid use for acute treatment of migraine is of concern because it may be associated with dependence, suboptimal outcomes, and increased risk of new-onset chronic migraine (CM).
To identify variables associated with opioid use among those using acute prescription medications for migraine.
The Chronic Migraine Epidemiology and Outcomes (CaMEO) study identified persons with ICHD-III migraine from a Web panel demographically matched to the US population. We compared the features of self-reported opioid users (currently using opioids or having them on hand for migraine) and frequency of use with those of nonusers. Nested, multivariable binary logistic regression models evaluated opioid use/nonuse as the outcome. Covariates were entered in blocks (sociodemographics, headache and respondent characteristics, psychiatric comorbidities, emergency facility use for headache in the preceding 6 months, and ≥1 CV comorbidity). Nonsignificant sociodemographic variables were trimmed from the model.
Of 2,388 people with migraine currently using acute prescription medications, 867 (36.3%) were opioid users. Factors significantly associated (odds ratio [95% CI]) with opioid use included male sex (1.74 [1.38, 2.20]), increasing BMI (1.02 [1.00, 1.03]), allodynia (1.39 [1.14, 1.70]), increasing monthly headache day frequency (0-4 days [reference] vs 10-14 days: 1.37 [1.02, 1.82]; ≥15 days: 1.62 [1.24, 2.13]), increasing Total Pain Index (TPI) (excluding head, face, neck; 1.32 [1.15, 1.52]), anxiety (1.37 [1.08, 1.73]), depression (1.50 [1.18, 1.89]), ≥1 CV comorbidity (1.56 [1.28, 1.90]), and emergency facility use for headache (1.73 [1.30, 2.31]). Physician-diagnosed migraine or CM was associated with a significantly decreased likelihood of opioid use (0.38 [0.30, 0.48]).
Opioid use is common among migraine patients using prescription medication and is generally associated with markers of worse health, including elevated BMI, CV and psychiatric comorbidities, elevated TPI, and emergency facility use. Modifiable variables associated with opioid use include presence/absence of physician diagnosis and monthly headache days.
Authors/Disclosures
Richard B. Lipton, MD, FAAN (Albert Einstein College of Medicine)
PRESENTER 		Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biohaven. Dr. Lipton has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GlaxoSmithKline. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vedanta. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Grifols. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axon. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Satsuma. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cool Tech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BDSI. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axsome. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Clexio. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shiratronics. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Lipton has stock in Biohaven. Dr. Lipton has stock in Manistee. Dr. Lipton has stock in Axon. Dr. Lipton has stock in CoolTech. The institution of Dr. Lipton has received research support from Teva. The institution of Dr. Lipton has received research support from Amgen. The institution of Dr. Lipton has received research support from Allergan/Abbvie. The institution of Dr. Lipton has received research support from Gammacore. The institution of Dr. Lipton has received research support from Axsome. The institution of Dr. Lipton has received research support from Charleston Labs. The institution of Dr. Lipton has received research support from Eli Lilly. The institution of Dr. Lipton has received research support from Satsuma. The institution of Dr. Lipton has received research support from NIH . The institution of Dr. Lipton has received research support from Veterans Administration. Dr. Lipton has received publishing royalties from a publication relating to health care.
Todd J. Schwedt, MD, FAAN (Mayo Clinic) Dr. Schwedt has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. Dr. Schwedt has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Schwedt has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. Dr. Schwedt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Schwedt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Theranica. Dr. Schwedt has received personal compensation in the range of $0-$499 for serving as a Consultant for Amgen. Dr. Schwedt has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Scilex. Dr. Schwedt has stock in Aural Analytics. Dr. Schwedt has stock in Nocira. Dr. Schwedt has stock in Allevalux. The institution of Dr. Schwedt has received research support from National Institutes of Health. The institution of Dr. Schwedt has received research support from United States Department of Defense. The institution of Dr. Schwedt has received research support from Patient Centered Outcomes Research Institute. The institution of Dr. Schwedt has received research support from SPARK Neuro. The institution of Dr. Schwedt has received research support from Henry Jackson Foundation. The institution of Dr. Schwedt has received research support from Pfizer. The institution of Dr. Schwedt has received research support from National Headache Foundation. The institution of Dr. Schwedt has received research support from American Heart Association. Dr. Schwedt has received intellectual property interests from a discovery or technology relating to health care. Dr. Schwedt has received intellectual property interests from a discovery or technology relating to health care. Dr. Schwedt has received intellectual property interests from a discovery or technology relating to health care. Dr. Schwedt has received intellectual property interests from a discovery or technology relating to health care. Dr. Schwedt has received publishing royalties from a publication relating to health care.
Benjamin Friedman No disclosure on file
Kristina M. Fanning, PhD (MIST Reserach) The institution of Dr. Fanning has received research support from Abbvie. The institution of Dr. Fanning has received research support from NYC Langone Health . The institution of Dr. Fanning has received research support from Uiversity of SC - Irvine. The institution of Dr. Fanning has received research support from AESARA.
Michael L. Reed, PhD (Vedanta Research) The institution of Dr. Reed has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eli Lilly. The institution of Dr. Reed has received research support from Allergan. The institution of Dr. Reed has received research support from Dr Reddy's Labs/Promius. The institution of Dr. Reed has received research support from Allay Lamp. Dr. Reed has a non-compensated relationship as a Research Analyst with National Headache Foundation that is relevant to AAN interests or activities.
Aubrey Adams, PhD Dr. Manack Adams has received personal compensation for serving as an employee of Abbvie. Dr. Manack Adams has stock in Abbvie.
Dawn C. Buse, PhD (Dawn C. Buse, PhD) Dr. Buse has received personal compensation for serving as an employee of Vector Psychometric Group. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie-Allergan. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amgen. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lilly. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Theranicsa. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lilly. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie-Allergan. Dr. Buse has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Buse has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Current Pain and Headache Reports. The institution of Dr. Buse has received research support from Amgen. The institution of Dr. Buse has received research support from FDA. The institution of Dr. Buse has received research support from National Headache Foundation.