title: Opioid use 12 months following interdisciplinary pain rehabilitation with weaning.
abstract: OBJECTIVE
  To examine the frequency of and factors predicting opioid resumption among patients with chronic non-cancer pain (CNCP) and therapeutic opioid addiction (TOA) treated in an interdisciplinary chronic pain rehabilitation program (CPRP) incorporating opioid weaning.
  
  
  METHODS
  Longitudinal retrospective treatment outcome study. Only those with addiction were counseled to avoid opioids for non-acute pain.
  
  
  METHODS
  Large academic medical center.
  
  
  METHODS
  One hundred twenty patients, 32.5% with TOA. Participants were predominately married (77.5%), females (66.7%). Mean age was 49.5 (±13.7). 29.2% had lifetime histories of non-opioid substance use disorders.
  
  
  METHODS
  TOA was diagnosed using consensus definitions developed by American Academy of Pain Medicine, American Pain Society and American Society of Addiction Medicine to supplement Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR) criteria. Non-opioid substance use disorders were diagnosed using DSM-IV-TR. Data, including pain severity, depression and anxiety, were collected at admission, discharge and 12 months. Opioid use during treatment was based on medical records and use at 12 months was based on self-report.
  
  
  RESULTS
  Only 22.5% reported resuming use at 12 months. Neither patients with TOA nor patients with non-opioid substance use disorders were more likely to resume use than those without substance use disorders. Only posttreatment depression increased the probability of resumption.
  
  
  CONCLUSIONS
  CNCP and co-occurring TOA can be successfully treated within a CPRP. Patients report low rates of resumption regardless of addiction status. This is in marked contrast to reported outcomes of non-medically induced opioid addictions. Prolonged abstinence may depend upon the successful treatment of depression.
authors.affiliation: Cleveland Clinic Neurological Center for Pain, Cleveland, Ohio, USA; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Huffman
authors.forename: Giries W
authors.initials: GW
authors.lastname: Sweis
authors.forename: Allison
authors.initials: A
authors.lastname: Gase
authors.forename: Judith
authors.initials: J
authors.lastname: Scheman
authors.forename: Edward C
authors.initials: EC
authors.lastname: Covington
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000188:drug therapy* / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D059408:Pain Management / Q000379:methods*; D012189:Retrospective Studies
keywords: Chronic Non-Cancer Pain; Opioid Dependence; Pain Rehabilitation; Therapeutic Opioid Addiction