A longitudinal study of opioid use, misuse, and co-use of other substances: Related changes in outcomes after spinal cord injury. - Our goal is to conduct longitudinal research to describe opioid use, misuse, and co-use of other substances, associated risk factors, and their consequences among those with traumatic spinal cord injury (SCI). We will use a mixed methods approach, building upon the 30-year SCI Longitudinal Health Study, the most recent stage of which was focused on opioids and other substances. We will conduct a five-year follow-up of existing participants (1396 projected responses) while enrolling 1000 new participants from population-based registries. Our objectives are to identify: (1) self-reported prevalence and five-year changes in prescription opioid use, misuse, and co-use of other prescription and non-prescription substances, including benzodiazepines, gabapentinoids, and cannabis; (2) person and environmental risk factors of use, misuse, co-use and change in use; and (3) the relationships of change in use with five-year changes in health, participation, and employment. Qualitative focus groups using 40 participants with a history of opioid use will identify perceived benefits and drawbacks of prescription opioids in the self-management of pain and other secondary conditions. An advisory panel with lived experience and an external advisory panel will assist with the design, implementation, dissemination, and development of utilization strategies. Anticipated outcomes include new knowledge to guide policy, clinical practice, prevention, and self-management strategies that will ultimately lead to a reduction in the risk of use, misuse, co-use, overdose, and SCI related secondary conditions. We will develop and disseminate multiple products and tools to promote the translation of our research findings including: (1) individualized risk calculators, (2) guidelines for prevention, and (3) research briefs. We will disseminate through multiple publications, presentations, webcasts, and newsletters.
