title: Outcome from integrated pain management treatment for recovering substance abusers.
abstract: There is little information on the efficacy of pain management for substance abusers with noncancerous chronic pain conditions. The present study describes an outcome evaluation of a pain management group adapted to the needs of patients diagnosed with concurrent chronic pain and substance abuse disorders. A heterogeneous group of 44 patients (66% opioid dependent; 61% musculoskeletal pain) attended a 10-week outpatient group based within a multidisciplinary substance abuse treatment program. Measures of addiction severity, pain, use of self-management techniques, emotional distress, medication use, and functional status were obtained at pretreatment, post-treatment, 3-month, and 12-month follow-ups. Outcome data were analyzed on the group and individual level, the latter using the reliable change index. Intention-to-treat analyses showed significant improvements in pain, emotional distress, medication reduction, and coping style. Half of the patients showed a statistically reliable improvement on at least 1 outcome measure, and half were opioid free at the 12-month follow-up assessment. These results suggest that persons with concurrent chronic pain and substance use disorders are responsive to an integrated treatment model of pain management and relapse prevention.
authors: Addiction Centre, Medical Centre, Calgary, Alberta, Canada. Scurrie@ucalgary.ca
authors: Shawn R
authors: SR
authors: Currie
authors: David C
authors: DC
authors: Hodgins
authors: Ann
authors: A
authors: Crabtree
authors: Jacquie
authors: J
authors: Jacobi
authors: Susan
authors: S
authors: Armstrong
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000628:therapy; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D018710:Pain Clinics; D010147:Pain Measurement; D010358:Patient Participation; D055502:Secondary Prevention; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid