# Opioid Prescribing and Chronic Pain in the Primary Care Setting

> **NIH NIH F30** · HARVARD MEDICAL SCHOOL · 2021 · $40,559

## Abstract

Project Summary/Abstract
Amidst high levels of chronic pain, the United States (U.S.) has seen a concurrent opioid overdose epidemic
that has led to the deaths of an estimated 702,000 people between 1999 and 2017. In response to the
dramatic rise in opioid-related overdose deaths, a large proportion of interventions have targeted opioid
prescribing and pain management. State, federal, and professional organization agencies have implemented
changes intended to curb inappropriate opioid prescribing, particularly in the primary-care setting. This includes
the release of the CDC Guideline for Prescribing Opioids for Chronic Pain in March 2016, a set of
recommendations for primary-care opioid use in pain management. Between 2012 and 2018, U.S. opioid
prescribing rates have subsequently fallen by more than one third. These changes have affected the estimated
1.6 million people with opioid use disorder and 50 million people with chronic pain. Concerns about the
misapplication of guidelines have arisen, particularly in decisions to reduce or discontinue opioid prescribing
among patients with chronic pain. The overall goal of this study is therefore to better characterize the
impacts of new opioid prescribing guidelines and associated prescribing patterns for the treatment of
chronic pain in the primary-care setting. All three specific aims draw from a hospital-system cohort of
primary-care patients with chronic pain who are prescribed chronic opioids. Aim 1 consists of an interrupted
time-series analysis to determine the magnitude of changes to opioid prescribing by dose, duration, and
prescription type after the implementation of new opioid prescribing guidelines. Aim 2 entails semi-structured
interviews with patients with chronic pain to explore the impact of prescribing and pain management changes
on quality of life, functioning, pain management, opioid use, healthcare utilization, and perceptions of health
equity. Aim 3 involves mediation analysis to determine whether certain patient groups have been
disproportionately affected by opioid prescribing changes, particularly by race or socioeconomic status. The
proposed research thus aligns with the National Institute on Drug Abuse’s (NIDA) stated goal to better
understand the consequences of recent clinical care guideline implementation on opioid prescribing for pain
management as well as its mission to support clinical research on substance use and associated disorders.
The fellowship training plan includes rigorous methodological training in quantitative epidemiological and
clinical ethnographic methods in a vibrant, multidisciplinary training environment. Through training and
research, this proposal will help to better characterize the effects of recent efforts to reduce inappropriate
opioid prescribing and the associated impacts on patient safety, patient wellbeing, and health equity. Such
knowledge has the potential to improve chronic pain care and outcomes, promote responsible opioid
prescribing, ...

## Key facts

- **NIH application ID:** 10311247
- **Project number:** 1F30DA052116-01A1
- **Recipient organization:** HARVARD MEDICAL SCHOOL
- **Principal Investigator:** Katherine Elida Warren
- **Activity code:** F30 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $40,559
- **Award type:** 1
- **Project period:** 2021-08-01 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10311247

## Citation

> US National Institutes of Health, RePORTER application 10311247, Opioid Prescribing and Chronic Pain in the Primary Care Setting (1F30DA052116-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10311247. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*