Exploring relations among traumatic, posttraumatic, and physical pain experiences in methadone-maintained patients.
Differences in lifetime trauma exposure and screened symptoms of posttraumatic stress disorder (PTSD) were examined in methadone maintenance treatment (MMT) patients with a variety of pain experiences. Parametric and nonparametric statistical tests were performed on data obtained from 150 patients currently enrolled in MMT. 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 comparable levels of trauma involving sexual assault but reported significantly higher levels of trauma involving physical assault, number of traumatic events, and screened symptoms of PTSD. A third group, non-CSP MMT patients reporting some pain in the past week, differed significantly from the CSP group on number of traumatic events but reported comparable levels of sexual assault and physical assault. In comparison to men, women reported higher levels of sexual assault and were more likely to score above the cutoff on the PTSD screener but reported comparable levels of physical assault and number of traumatic events. Pain-related differences in trauma and screened symptoms of PTSD exist in MMT patients and may have implications for program planning and outreach efforts.


CONCLUSIONS
This article demonstrates that trauma and screened symptoms of PTSD vary as a function of sex and pain status in methadone-maintained patients. Future studies may benefit from developing and assessing interventions that address chronic pain, PTSD, and opioid dependence in MMT.
Barry
Declan T
DT
Yale University School of Medicine, 34 Park Street, New Haven, CT 06519, USA. declan.barry@yale.edu
Beitel
Mark
M
Cutter
Christopher J
CJ
Garnet
Brian
B
Joshi
Dipa
D
Rosenblum
Andrew
A
Schottenfeld
Richard S
RS
D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008691:Methadone / Q000009:adverse effects*; D008875:Middle Aged; D015999:Multivariate Analysis; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D010146:Pain / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult
D000701:Analgesics, Opioid; D008691:Methadone