Psychosocial Pain Management During Addictions Treatment to Improve Outcomes
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Chronic Pain |
| Therapuetic Areas: | Musculoskeletal |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | October 2011 |
| End Date: | September 2016 |
The present intervention is a Stage II randomized controlled efficacy trial of a group-based
intervention that integrates Cognitive Behavioral Therapy (CBT) for pain and substance use
disorders (SUDs) compared to a Supportive Psychoeducation Control (SPC) group in a sample of
patients receiving residential SUD treatment with co-occurring chronic pain. A total of 452
patients (226 male and 226 female) with current pain rated as moderately severe or greater
and comorbid drug or alcohol use disorder(s) will be recruited from a large residential SUD
treatment program. These participants will be randomly assigned to either a 4-week
(8-session) group of integrated CBT for pain and SUDs or a 4-week (8-session) SPC group. All
participants will be re-assessed immediately post-treatment (1 month) and again at 3, 6, and
12 months post-intervention. Through this randomized controlled trial, the investigators
hope to gain insight on how to improved treatment of pain in those with SUDs that could
result in enhanced quality of life and improved pain-related, substance use, and other
health outcomes. Evaluating a psychosocial intervention for pain and substance use that can
be delivered during a SUD treatment episode would significantly extend available treatment
options for the large numbers of patients with pain seen by SUD treatment providers. The
investigators also hope to determine the efficacy of an evidence-based psychosocial pain
management approach in men and women from a large and diverse residential addiction
treatment program.
intervention that integrates Cognitive Behavioral Therapy (CBT) for pain and substance use
disorders (SUDs) compared to a Supportive Psychoeducation Control (SPC) group in a sample of
patients receiving residential SUD treatment with co-occurring chronic pain. A total of 452
patients (226 male and 226 female) with current pain rated as moderately severe or greater
and comorbid drug or alcohol use disorder(s) will be recruited from a large residential SUD
treatment program. These participants will be randomly assigned to either a 4-week
(8-session) group of integrated CBT for pain and SUDs or a 4-week (8-session) SPC group. All
participants will be re-assessed immediately post-treatment (1 month) and again at 3, 6, and
12 months post-intervention. Through this randomized controlled trial, the investigators
hope to gain insight on how to improved treatment of pain in those with SUDs that could
result in enhanced quality of life and improved pain-related, substance use, and other
health outcomes. Evaluating a psychosocial intervention for pain and substance use that can
be delivered during a SUD treatment episode would significantly extend available treatment
options for the large numbers of patients with pain seen by SUD treatment providers. The
investigators also hope to determine the efficacy of an evidence-based psychosocial pain
management approach in men and women from a large and diverse residential addiction
treatment program.
Chronic pain among individuals who misuse drugs or alcohol is a common and critically
important problem that is rarely managed appropriately. The estimated rates of chronic pain
in Substance Use Disorder (SUD) treatment are as high as 60%. Chronic pain is seldom
successfully addressed in SUD treatment settings because of a limited understanding of the
problem and a lack of effective intervention strategies. A clear and urgent need exists for
the study of effective alternatives to the use of opiate pain medications in those treated
for SUDs who also have pain because of: (1) the potential for abuse and diversion of opiate
medications by patients in SUD treatment; and (2) recent evidence that untreated pain may
undermine the effectiveness of standard treatments for SUDs.
An important potential strategy to address this problem is the use of Cognitive Behavioral
Therapy (CBT) to manage pain and decrease substance misuse. Psychosocial interventions such
as CBT have demonstrated efficacy for reducing pain and improving functioning for a broad
spectrum of pain-related conditions. However, this form of treatment has not been explicitly
tested in patients with co-occurring substance use disorders. Additionally, although pain is
common in both men and women, most studies have lacked sufficient power to test the effect
of interventions separately in men and women. The present intervention is designed to
integrate CBT for pain and CBT for SUDs with the primary goal of improving pain- and
substance-related outcomes. The investigators will test the efficacy of this modified
protocol on both men and women in this understudied patient population.
important problem that is rarely managed appropriately. The estimated rates of chronic pain
in Substance Use Disorder (SUD) treatment are as high as 60%. Chronic pain is seldom
successfully addressed in SUD treatment settings because of a limited understanding of the
problem and a lack of effective intervention strategies. A clear and urgent need exists for
the study of effective alternatives to the use of opiate pain medications in those treated
for SUDs who also have pain because of: (1) the potential for abuse and diversion of opiate
medications by patients in SUD treatment; and (2) recent evidence that untreated pain may
undermine the effectiveness of standard treatments for SUDs.
An important potential strategy to address this problem is the use of Cognitive Behavioral
Therapy (CBT) to manage pain and decrease substance misuse. Psychosocial interventions such
as CBT have demonstrated efficacy for reducing pain and improving functioning for a broad
spectrum of pain-related conditions. However, this form of treatment has not been explicitly
tested in patients with co-occurring substance use disorders. Additionally, although pain is
common in both men and women, most studies have lacked sufficient power to test the effect
of interventions separately in men and women. The present intervention is designed to
integrate CBT for pain and CBT for SUDs with the primary goal of improving pain- and
substance-related outcomes. The investigators will test the efficacy of this modified
protocol on both men and women in this understudied patient population.
Inclusion Criteria:
- Must be over 18 years of age
- Report moderate to severe pain over past 3 months
- Resided in treatment for less than 60 days
Exclusion Criteria:
- Acute suicidality
- Mental incompetence (e.g. unable to provide informed consent)
- Evidence of current psychosis
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