Increased prescribing of opioids for chronic noncancer pain is associated with significant social costs, including overdose and addiction. In this context, there is interest in interdisciplinary chronic pain rehabilitation programs focusing on self-management and minimizing opioid use. This study examined outcomes of patients weaned from opioids in an ICPRP from 2007 to 2012. Participants included 413 patients on high dose chronic opioid therapy (COT; >100 mg), 528 on low dose COT, and 516 not on opioids (NO). Outcomes were assessed at discharge, 6, and 12 months posttreatment through self-report and chart review. One thousand one hundred ninety-four participants completed treatment (81.95%); 86.74% of those on opioids were weaned. High doses were less likely to complete (78.45%) than NO participants (85.27%; P < 0.05). Results showed immediate (P < 0.01) and sustained improvements (P < 0.05) in pain severity, depression, anxiety, and functional impairment with no group differences. Effect sizes ranged from medium to large (Cohen d values 0.57-1.96). Longitudinal medication use data were available for 319 no dose and 417 weaned participants; opioid resumption rates were 10.51% and 30.70% respectively. There were no differences in resumption between the high dose and low dose groups. Logistic regression analyses determined that opioid dose predicted neither treatment completion nor opioid resumption. Anxiety predicted completion, and functional impairment predicted opioid resumption within 1 year of discharge. Results suggest that patients on COT can be successfully weaned with long-term benefits in pain, mood, and function. Targeting anxiety and functional restoration may increase success rates.
Though the debate over the validity of qualitative research and its existence within the field of psychology has somewhat diminished over the years, negotiations over its location and form continue. This article examines the pressure on qualitative researchers to acculturate and adapt in order to gain legitimacy and acceptance in a field dominated by quantitative research. We treat the emergence of qualitative methods as a form of contact between differing (research) cultures, with the concomitant adjustments and accommodations, and we utilize Berry's (1980Berry's ( , 2005 typology of acculturation as a lens through which to examine these intercultural interactions. We examine, in particular detail, the experiences of qualitative researchers within counseling psychology, as that is the subdiscipline which has most explicitly defined itself as welcoming qualitative research. It is our view that qualitative researchers, within psychology in general, have adopted an acculturation strategy of assimilation rather than integration as defined by Berry (1980). We discuss the implications of this stance for the diversification of research methodologies in psychology.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.