title: Characterizing pain and associated coping strategies in methadone and buprenorphine-maintained patients.
abstract: BACKGROUND
  Chronic pain is common among patients receiving opioid maintenance treatment (OMT) for opioid use disorder. To aid development of treatment recommendations for coexisting pain and opioid use disorder, it is necessary to characterize pain treatment needs and assess whether needs differ as a function of OMT medication.
  
  
  METHODS
  A point-prevalence survey assessing pain and engagement in coping strategies was administered to 179 methadone and buprenorphine-maintained patients.
  
  
  RESULTS
  Forty-two percent of participants were categorized as having chronic pain. Methadone patients had greater severity of pain relative to buprenorphine patients, though both groups reported high levels of interference with daily activities, and participants with pain attended the emergency room more frequently relative to participants without pain. Only 2 coping strategies were being utilized by more than 50% of participants (over-the-counter medication, prayer).
  
  
  CONCLUSIONS
  Results indicate that pain among OMT patients is common, severe, and of significant impairment. Methadone patients reported greater severity pain, particularly worse pain in the past 24h, though interference from pain in daily activities did not vary as a function of OMT. Most participants with pain were utilizing few evidenced-based pain coping strategies. Increasing OMT patient access to additional pain treatment strategies is an opportunity for immediate intervention, and similarities across OMT type suggest interventions do not need to be customized to methadone vs. buprenorphine patients.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States. Electronic address: kdunn9@jhmi.edu.
authors.forename: Kelly E
authors.initials: KE
authors.lastname: Dunn
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
authors.forename: Patrick H
authors.initials: PH
authors.lastname: Finan
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
authors.forename: D Andrew
authors.initials: DA
authors.lastname: Tompkins
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
authors.forename: Michael
authors.initials: M
authors.lastname: Fingerhood
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
authors.forename: Eric C
authors.initials: EC
authors.lastname: Strain
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D002047:Buprenorphine / Q000627:therapeutic use; D059350:Chronic Pain / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D060046:Maintenance Chemotherapy; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000523:psychology*; D059408:Pain Management / Q000523:psychology*; D017288:Pain Threshold / Q000523:psychology*; D015995:Prevalence
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine; D008691:Methadone
keywords: Buprenorphine; Chronic pain; Coping; Methadone; Opioid