Prevalence and Characteristics of Chronic Pain in Patients Admitted to an Outpatient Drug and Alcohol Treatment Program

Abstract

Chronic severe pain was prevalent in this predominantly employed, alcoholic population attending an outpatient drug and alcohol treatment program. Pain was associated with significant functional impairment, medical and psychiatric comorbidities, and abuse behaviors. Few patients accessed adequate pain treatment. Efforts should be made to better address the pain problems in this patient population.

Chronic Pain and DepressionAmong Primary Care Patients Treated with Buprenorphine

“…44,45 To assess pain severity, we asked participants to rate their average overall pain in the past week on a 0-100 scale, with 0 being no pain and 100 being pain Bas bad as you can imagine.^4 4 We defined three groups: no chronic pain (some of whom had acute pain lasting less than 6 months), mild chronic pain (i.e., pain severity between 0 and 39 in the past week, and pain for at least 6 months) moderate/severe chronic pain (i.e., pain severity was ≥ 40 in the past week and pain for at least 6 months). We chose this cutoff based on its use as a threshold for inclusion in clinical trials of analgesics.…”

“…1 Buprenorphine/naloxone (referred to here as buprenorphine), a long-acting partial opioid agonist, has emerged as a viable alternative to methadone with comparable outcomes and can be prescribed in primary care settings. 2 Patients with a history of opioid use report high rates of experiencing pain [3][4][5] that is often severe and interferes with daily activities. [3][4][5][6][7][8] Indeed, a large percentage of patients with opioid dependence who receive opioid agonist treatment report that pain preceded any use of addictive substances, 3,6,[9][10][11] and that the primary reason for starting opioid use was to reduce pain.…”

Pain and Associated Substance Use among Opioid Dependent Individuals Seeking Office-Based Treatment with Buprenorphine-Naloxone: A Needs Assessment Study

“…18 Research findings point to the importance of assessing recent pain (i.e., pain experienced in the past week) as well as chronic pain among opioid dependent patients entering treatment. 2,19,20 Therefore, the aim of this needs assessment study was to examine the pain experiences of opioid dependent individuals seeking BNT. Specifically, we set out to examine, among those seeking BNT: (a) the prevalence of pain types (i.e., recent pain, chronic pain), (b) the characteristics of pain (intensity, frequency, duration, interference, location, and genesis), and (c) substance use to alleviate pain.…”

Association of Chronic Noncancer Pain With Substance Abuse Treatment Outcomes Among a Community Mental Health Center Sample

“…14 However, there remains limited data examining the co-occurrence of substance use with CNCP and how these 2 conditions might exacerbate each other, as well as have an effect on relapse after substance abuse treatment. Among individuals in substance abuse treatment, 18% to 67% report experiencing CNCP, [15][16][17][18][19][20][21] whereas only 13% report receiving treatment for their pain symptoms. 21 One hypothesis is that the nonmedical use of prescription drugs, particularly opioids, may be a self-medication of untreated or undertreated CNCP.…”

“…Among individuals in substance abuse treatment, 18% to 67% report experiencing CNCP, [15][16][17][18][19][20][21] whereas only 13% report receiving treatment for their pain symptoms. 21 One hypothesis is that the nonmedical use of prescription drugs, particularly opioids, may be a self-medication of untreated or undertreated CNCP. 3,22 Comorbid CNCP and drug or alcohol dependence can make effective treatment of the 2 conditions difficult to coordinate.…”