Substance Abuse Treatment for High Risk Chronic Pain Patients on Opioid Therapy

Brigham and Women's Hospital84 enrolled

Overview

Chronic back pain patients are often dismissed from a pain center or a primary care practice when they are noncompliant with opioid therapy, instead of being offered treatments to reduce misuse and to improve compliance. Unfortunately, there are few treatment resources for such patients. This study seeks to remedy that problem, with the goal of reducing the rate of prescription opioid misuse among noncompliant patients through the use of novel tracking, education, and counseling interventions.

This study will evaluate drug misuse behavior over 6 months with the use of self-report questionnaires, physician ratings, urine toxicology screens, and electronic diary data.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Substance Abuse

Interventions

cognitive behavioral trainingBEHAVIORAL

electronic diaries, compliance checklists, urine screens, individual and group motivational counseling

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * chronic pain for \>6 months * history of taking daily opioids for pain for \>6 months * average \>3 on a pain intensity scale of 0 to 10 over past week * able to speak and understand English * chronic neck or back pain as primary pain complaint * willingness to participate Exclusion Criteria: * current opioid addiction (M.I.N.I. Section K) * current diagnosis of cancer or any other malignant disease * acute osteomyelitis or acute bone disease * nonambulatory * present or past DSM-IV diagnosis of schizophrenia, delusional disorder, psychotic disorder, or dissociative disorder * pregnancy * any clinically unstable systemic illness judged to interfere with treatment * an acute condition requiring surgery * taking opioids intermittently

Locations (1)

Brigham and Women's Hospital Pain Management Center

Chestnut Hill, Massachusetts, United States

Outcomes

Primary Outcomes

Drug Misuse Index: 1) physician ratings of misuse (ABC), 2) structured self-report interview (PDUQ), and 3) urine tox screens

Time frame: All subjects will be followed for 6 months.

Secondary Outcomes

1) Rate of patient dismissal from a pain center, 2) treatment satisfaction ratings

Time frame: Subjects will be followed for 6 months.

Data from ClinicalTrials.gov

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