title: Response to methadone maintenance treatment of opiate dependent patients with and without significant pain.
abstract: BACKGROUND
  Both clinicians and researchers have expressed doubt that opiate dependent patients with significant pain can be effectively treated in methadone maintenance treatment (MMT) programs; however, little research exists on this topic. Patients who report significant pain in the month preceding entry to MMT present with a distinct and more severe pattern of polysubstance use, medical and psychosocial problems than do those without pain. The present study investigated the 1-year treatment outcomes of MMT patients with opiate dependence and pain.
  
  
  METHODS
  Analyses were based on a national sample of 200 patients presenting in MMT programs for treatment of opiate dependence. Substance use and related problems were measured at treatment entry and 12 months later. Patients reported pain severity over the month preceding treatment entry.
  
  
  RESULTS
  Compared to patients without significant pain, patients who reported significant pain at baseline (n = 103) showed similar substance-related functioning, but poorer psychosocial functioning at 1 year.
  
  
  CONCLUSIONS
  Patients with and without significant pain experience comparable reductions in substance use when provided with standard care in MMT programs. However, additional medical and/or mental health treatment is needed for their pain and other problems.
authors.affiliation: Center for Health Care Evaluation, Department of Veterans Affairs Palo Alto Health Care System and Stanford University School of Medicine, 795 Willow Road (MPD 152), Menlo Park, CA 94025, USA. mark.ilgen@med.va.gov
authors.forename: Mark A
authors.initials: MA
authors.lastname: Ilgen
authors.forename: Jodie A
authors.initials: JA
authors.lastname: Trafton
authors.forename: Keith
authors.initials: K
authors.lastname: Humphreys
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation*; D010146:Pain / Q000503:physiopathology*; D017060:Patient Satisfaction; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014768:Virginia
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone