Allopathic, Complementary, and Alternative Medical Treatment Utilization for Pain among Methadone-Maintained Patients

Abstract

We surveyed 150 methadone maintenance treatment program (MMTP) patients about pain, pain treatment utilization, perceived efficacy of prior pain treatment, and interest in pursuing pain treatment at the MMTP. Respondents with chronic severe pain (CSP) (i.e., pain lasting at least 6 months with moderate to severe pain intensity or significant pain interference) and “some pain” (i.e., pain reported in the previous week but not CSP) endorsed similar rates of past-week and lifetime allopathic or standard medical (with the exception of lifetime medical use of non-opiate medication) and complementary and alternative medicine (CAM) utilization for pain reduction. Prior pain treatments were perceived to be less effective by CSP than SP patients but both groups had equivalent high rates of interest in pain treatment associated with the MMTP. These findings may have implications for resource and program planning in MMT programs.

Chronic Pain and DepressionAmong Primary Care Patients Treated with Buprenorphine

“…However, compared to those without pain, buprenorphine patients with pain (again in a graded fashion based on severity of pain) reported higher misuse rates of additional substances that may produce analgesia, including cocaine, alcohol, and marijuana. 10,12,27 Patients may view this ongoing use of non-prescribed, psychoactive drugs during buprenorphine treatment as self-medication of pain and/or psychiatric symptoms, or as an attempt to improve subjective well-being. 6,7,11,13,34 Nonetheless, ongoing use of other nonprescribed substances may lead to discharge from buprenorphine treatment.…”

“…Nor did we assess use of alternative medicine treatments for pain relief. 27,62 Although buprenorphine maintenance treatment has many health benefits, and buprenorphine has analgesic properties, full relief from chronic pain should not be expected. Still, the physical and psychological distress of patients with pain influences the perception of treatment benefits by both patients and providers.…”

“…26 Pain also complicates ongoing opioid dependence treatment as sufferers often misuse other substances such as marijuana, alcohol, and cocaine to seek relief. 10,27 Depression is another common comorbidity among opioid dependent persons. Approximately one-third to one-half of buprenorphine and methadone recipients suffer from clinically meaningful depressive symptoms that may or may not meet Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for major depressive disorder.…”

Group-Based Strategies for Stress Reduction in Methadone Maintenance Treatment: What Do Patients Want?

“…Whereas we previously reported on a) the prevalence of pain and associated substance use and psychiatric correlates, b) prior pain treatment utilization, and c) perceptions of individual psychosocial interventions among the study sample, we did not report on findings related to willingness to use stress-reducing conventional and unconventional group treatments or the perceived efficacy of such interventions (Barry et al, 2009a;Barry et al, 2009b;Barry et al, in press-a). The primary goal of this needs assessment study was to examine treatment willingness and perceived efficacy of nonpharmacological conventional and unconventional group treatments for managing stress.…”

Drug Counselors’ Attitudes Toward Nonpharmacologic Treatments for Chronic Pain

“…Participants supplied demographic data (i.e., gender, racial/ethnic background, age, years of clinical experience, and highest level of education) and were provided with a list of interventions and response cards based on prior research (Barry et al 2009a; Barry et al 2010; Barry et al 2012), informed that “People with persistent pain may benefit from a variety of treatments,” and asked, “If the following treatments were available to your patients with persistent pain, how willing would you be to refer them?” “Also, how effective do you think that they would be for your pain patients?” With the exception of massage therapy, heat therapy, ice therapy, chiropractic treatment, and Reiki, which were assessed only as individual-based treatments, participants rated individual and group versions of each treatment using 5-point Likert-type scales for willingness [0 (“Not willing at all”) to 4 (“Completely willing”)] and perceived efficacy [0 (“Not effective at all”) to 4 (“Completely effective”)].…”