title: A randomized trial of a pain management intervention for adults receiving substance use disorder treatment.
abstract: Chronic pain is difficult to treat in individuals with substance use disorders and, when not resolved, can have a negative impact on substance use disorder treatment outcomes. This study tested the efficacy of a psychosocial pain management intervention, ImPAT (improving pain during addiction treatment), that combines pain management with content related to managing pain without substance use.
  
  
  
  Single-site, parallel-groups randomized controlled trial comparing ImPAT to a supportive psychoeducational control (SPC) condition; follow-up assessments occurred at 3, 6 and 12 months.
  
  
  
  The Ann Arbor VA Substance Use Disorder treatment program, USA.
  
  
  
  Veterans Health Administration patients {n = 129; mean [standard deviation (SD)], age = 51.7 (9.5); 115 of 129 (89%) male; ImPAT (n = 65); SPC (n = 64)}.
  
  
  
  ImPAT combines principles of cognitive-behavioral therapy and acceptance-based approaches to pain management with content related to avoiding the use of substances as a coping mechanism for pain. The SPC used a psychoeducational attention control treatment for alcoholism modified to cover other substances in addition to alcohol.
  
  
  
  Primary: Pain intensity over 12 months; secondary: pain-related functioning, frequency of alcohol and drug use over 12 months.
  
  
  
  Primary: randomization to the ImPAT intervention versus SPC predicted significantly lower pain intensity {β [standard error (SE)] = -0.71 (0.29); 95% confidence interval (CI) = -1.29, -0.12}; secondary: relative to the SPC condition, those who received ImPAT also reported improved pain-related functioning [β (SE) = 0.27 (0.11); 95% CI = 0.05, 0.49] and lower frequency of alcohol consumption [β (SE) = -0.77; 95% CI = -1.34, -0.20]. No differences were found between conditions on frequency of drug use over follow-up.
  
  
  
  For adults with pain who are enrolled in addictions treatment, receipt of a psychological pain management intervention (improving pain during addiction treatment) reduced pain and alcohol use and improves pain-related functioning over 12 months relative to a matched-attention control condition.
authors.affiliation: VA Center for Clinical Management Research (CCMR), Veterans Health Administration, Ann Arbor, MI, USA.|Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Ilgen
authors.affiliation: VA Center for Clinical Management Research (CCMR), Veterans Health Administration, Ann Arbor, MI, USA.|Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Amy S B
authors.initials: AS
authors.lastname: Bohnert
authors.affiliation: VA Center for Clinical Management Research (CCMR), Veterans Health Administration, Ann Arbor, MI, USA.|Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Chermack
authors.affiliation: School of Literature, Science and Arts, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Carly
authors.initials: C
authors.lastname: Conran
authors.affiliation: VA Center for Clinical Management Research (CCMR), Veterans Health Administration, Ann Arbor, MI, USA.|Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Jannausch
authors.affiliation: VA Program Evaluation and Resource Center (PERC), Veterans Health Administration, Menlo Park, CA, USA.|Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA.
authors.forename: Jodie
authors.initials: J
authors.lastname: Trafton
authors.affiliation: VA Center for Clinical Management Research (CCMR), Veterans Health Administration, Ann Arbor, MI, USA.|Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Frederic C
authors.initials: FC
authors.lastname: Blow
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D059350:Chronic Pain / Q000150:complications / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010353:Patient Education as Topic; D019966:Substance-Related Disorders / Q000150:complications / Q000628:therapy*
keywords: Cognitive-behavioral; pain; substance use disorder