Relations among psychopathology, substance use, and physical pain experiences in methadone-maintained patients.
OBJECTIVE
Differences in psychiatric distress and substance use (licit and illicit) were examined in methadone maintenance treatment (MMT) patients with a variety of pain experiences.


METHODS
Parametric and nonparametric statistical tests were performed on data obtained from 150 patients currently enrolled in MMT. Assessments were carried out at the 3 opioid agonist treatment programs operated by the APT Foundation, New Haven, Connecticut. Participants were recruited between March 2007 and March 2008.


RESULTS
In comparison to MMT patients reporting no pain in the previous week, those with chronic severe pain (CSP) (ie, pain lasting at least 6 months with moderate to severe pain intensity or significant pain interference) exhibited significantly higher (P < .01) levels of depression, anxiety, somatization, overall psychiatric distress, and personality disorder criteria but reported comparable rates of substance use. A third group, ie, non-CSP MMT patients reporting some pain in the past week, differed significantly (P < .05) from the other 2 pain groups on somatization and global psychiatric distress but reported comparable rates of substance use.


CONCLUSIONS
Pain-related differences in psychiatric problems exist in MMT patients and may have implications for program planning and outreach efforts.
Barry
Declan T
DT
Yale University School of Medicine, CMHC/SAC Room 220, 34 Park St., New Haven, CT 06519-1187, USA. declan.barry @yale.edu
Beitel
Mark
M
Garnet
Brian
B
Joshi
Dipa
D
Rosenblum
Andrew
A
Schottenfeld
Richard S
RS
D000328:Adult; D002908:Chronic Disease; D015897:Comorbidity; D003237:Connecticut / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology*; D010147:Pain Measurement / Q000706:statistics & numerical data; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology; D010555:Personality Inventory; D015995:Prevalence; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D011795:Surveys and Questionnaires
D008691:Methadone