Variation of questions in the patient-reported outcome (PRO) assessment optimizes patient understanding of liking of an opioid and desire to take it again. The patients suffering from chronic pain who were not recreational opioid users recognised the difference between analgesic and euphoric effects of an opioid, was explained in the studies published in 'Dovepress'.

The present PRO assessments examining the human abuse potential for opioid analgesics have been tested especially in experienced recreational opioid users, as per the US Food and Drug Administration (FDA) guidance.

This study aimed to modify items from FDA recommended abuse potential PRO assessment to determine the analgesic effects in comparison to the euphoric effects of opioids. It also evaluated whether the modified questions were clear, easily understood, appropriate, and valid. Cognitive debriefing interviews (CDIs) were conducted in patients (≥18 and <65 years) who have chronic pain. They have prescribed an opioid dose of at least 80 morphine-equivalent mg (>30 days to ≤180 days starting from the date of interview) daily. They did not have a history of recreational opioid use.

The participants in study 1 (n=30) and study 2 (n=7) had a better understanding of items designed to estimate the concepts of drug liking and items intended to estimate the desire to retake a drug when the reasons for liking and willingness to take again were considered in the item wording (i.e., “due to pain relief” and “excluding pain relief”). Most of the participants had no interest in taking their medication for reasons other than just pain relief. 

The investigators of this study added, "The modified questions will be helpful in encouraging future researchers to provide a more accurate evaluation of the abuse potential of an opioid as per the regulatory agencies."