Pain acceptance and opiate use disorders in addiction treatment patients with comorbid pain. (1st December 2015)

• Record Type: Journal Article
• Authors: Lin, Lewei (Allison); Bohnert, Amy S.B.; Price, Amanda M.; Jannausch, Mary; Bonar, Erin E.; Ilgen, Mark A.
• Is Part Of: Drug and alcohol dependence. Volume 157(2015)
• Page Start: 136
• Page End: 142
• Publication Date: 2015-12-01
• Subjects: Opioid -- Opiate -- Heroin -- Pain -- Acceptance -- Treatment; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2015.10.017
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Examined pain acceptance and opiate use in addiction treatment patients with pain. Lower pain acceptance was associated with greater severity of opiate use. Pain intensity was not associated with greater severity of opiate use. Pain acceptance may be a target of interventions to address co-occurring substance use and pain. Abstract: Objectives: Studies from pain treatment settings indicate that poor acceptance of pain may be an important and modifiable risk factor for higher severity of opioid use. However, the degree to which pain acceptance relates to opioid use severity in the addiction treatment population is unknown. In this study of addiction treatment patients with co-morbid pain, we examined correlates of severity of opiate (heroin and prescription opioid) use, with a particular focus on the role of pain acceptance. Methods: Patients in residential addiction treatment with comorbid pain ( N = 501) were stratified into low, moderate and high severity of opiate use. Demographic and clinical characteristics were compared across opiate severity categories. Results: 72% ( N = 360) of the participants had symptoms that were consistent with an opiate use disorder. Younger age, Caucasian race, female gender, cocaine use and lower pain acceptance were associated with higher severity of opiate use, whereas pain intensity was not. Controlling for demographic and other risk factors, such as substance use and pain intensity, higher pain acceptance was associated with lower odds of severe prescription opioid (AOR 0.50, 95% CI 0.38–0.68 for a one SD increase in pain acceptance) and heroin use (AOR 0.57, 95% CI 0.44–0.75 for a one SD increase in pain acceptance). Conclusions: Problematic opiate use is common in addictions treatment patients with chronic pain. Lower pain acceptance is related to greater opiate use severity, and may be an important modifiable target for interventions to successfully treat both pain and opiate use disorders.