title: Opioid cessation and multidimensional outcomes after interdisciplinary chronic pain treatment.
abstract: OBJECTIVE
  Although the efficacy of interdisciplinary treatment for chronic noncancer pain has been well-established in the literature, there is limited research examining interdisciplinary programs that require opioid cessation. As the long-term use of opioid analgesics remains controversial, further investigation is warranted. The aim of this study was to evaluate the associations between opioid cessation and subsequent multidomain treatment outcomes among veterans admitted to a pain rehabilitation program at a large Veterans Affairs tertiary care hospital in the southeastern United States.
  
  
  METHODS
  A retrospective design examined the medical records of 705 consecutive admissions comparing those using opioids at admission with those who were not. Participants taking opioids agreed to taper off of these medications using a "pain cocktail" approach; otherwise patients received identical treatment. Outcome measures were administered at program admission and discharge.
  
  
  RESULTS
  Repeated measures analyses were used to compare responses across time. Those who completed the program (n=600) demonstrated improvement in all outcome measures from admission to discharge, and the opioid group improved as much or more than the nonopioid group on all measures despite opioid cessation during treatment.
  
  
  CONCLUSIONS
  Results indicated that both groups experienced significant improvement on outcome measures, and that opioid analgesic use at admission had no discernible impact on treatment outcome in this large sample of veterans with moderate to severe chronic pain syndrome. The clinical implications of these findings for long-term chronic pain treatment, in light of the risks associated with opioid analgesics, are discussed.
authors: Chronic Pain Rehabilitation Program, James A. Haley Veterans' Hospital, Tampa, FL 33612, USA. jennifer.murphy2@va.gov
authors: Jennifer L
authors: JL
authors: Murphy
authors: Michael E
authors: ME
authors: Clark
authors: Evangelia
authors: E
authors: Banou
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology; D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D059350:Chronic Pain / Q000188:drug therapy / Q000453:epidemiology / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D010343:Patient Admission; D017060:Patient Satisfaction; D012189:Retrospective Studies; D012893:Sleep Wake Disorders / Q000209:etiology; D015144:Southeastern United States; D011795:Surveys and Questionnaires; D013997:Time Factors; D028761:Withholding Treatment / Q000706:statistics & numerical data*
chemical_list: D000701:Analgesics, Opioid