This study used data from the NIDA Clinical Trials Network’s Prescription Opioid Addiction Treatment Study (POATS) to examine pain trajectories and volatility in patients with chronic pain receiving buprenorphine/naloxone (BUP/NLX) treatment for prescription opioid addiction.
Secondary analyses of adults with chronic pain (n=149) who received BUP/NLX and counseling for 12 weeks in outpatient settings were performed. Good treatment outcome was defined as urine-verified abstinence from opioids at treatment endpoint (week 12) and during at least 2 of the previous 3 weeks.
Conclusions: The significant reduction in subjective pain during treatment provides observational support for the analgesic effects of BUP/NLX in patients with chronic pain and opioid dependence. Patients with greater volatility in subjective pain during treatment have increased risk of returning to opioid use by the conclusion of an intensive treatment with BUP/NLX and counseling.
Clinicians providing treatment for co-occurring prescription opioid addiction and chronic pain may want to consider monitoring pain volatility to monitor for risk for poor treatment outcomes and adjust treatment regimens accordingly. Future research should examine underlying mechanisms of pain volatility and identify related therapeutic targets to optimize interventions for prescription opioid addiction and co-occurring chronic pain.
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Funding for this Addiction Science Made Easy project is provided by the Addiction Technology Transfer Center National Office, under the cooperative agreement from the Center for Substance Abuse Treatment of SAMHSA.
Articles were written based on the following published research:
Worley MJ, et al. Pain Volatility and Prescription Opioid Addiction Treatment Outcomes in Patients With Chronic Pain. Experimental and Clinical Psychopharmacology 2015;23(6):428-435.