CBT Helps High-Risk Patients Taper off Opioids

By Boschert, Sherry | Clinical Psychiatry News, June 2012 | Go to article overview

CBT Helps High-Risk Patients Taper off Opioids


Boschert, Sherry, Clinical Psychiatry News


FROM THE ANNUAL MEETING OF THE AMERICAN ACADEMY OF PAIN MEDICINE

PALM SPRINGS, CALIF. -- An intensive interdisciplinary outpatient program successfully treated 246 patients at high risk of substance abuse, alongside 230 low-risk patients, for their debilitating chronic pain.

At the start of the 3-week pain rehabilitation program, the two groups did not differ significantly in their duration of pain (nearly 12 years on average) or duration of opioid use (6 years on average). They reported similar levels of pain severity.

The high-risk patients, however, had significantly worse scores on measures of depression, pain interference with life. pain catastrophizing, and perceived control of life and pain. Despite comparable pain severity and duration, they were taking significantly greater morphine-equivalent doses of pain medications, compared with doses taken by low-risk patients (124 vs. 60 mg/day).

By the end of the program, which incorporated substance abuse education and support, both the high-risk and low-risk groups had improved in all these measures, and there was no longer any significant difference in scores between the two groups, Sarah E. Hayes reported in an award-winning poster and plenary session at the meeting.

The intensive program at the Mayo Clinic, Rochester, Minn. provides more than can be offered in a typical ambulatory setting, coinvestigator Dr. Michael Hooten said in an interview. The results suggest that high-risk patients can be included in pain rehabilitation programs without affecting treatment outcomes, said Dr. Hooten of the Mayo Clinic.

Patients attend sessions 8 hours per day, 5 days per week, focused on functional restoration, withdrawal from opioids, and reduced polypharmacy rather than on attempted cures or interventional procedures for their chronic pain. Approximately 97% completely taper off of opioids, said Ms. Hayes, who conducted the study while she was a research associate at the Mayo Clinic and is now a student at New York University.

The interdisciplinary staff includes physicians, psychologists, pharmacists, nurses, physical therapists, and occupational therapists. The foundation of treatment is a cognitive-behavioral model that includes biofeedback, relaxation training, and stress management. Padents receive education in "chemical health" and in "wellness" topics such as sleep hygiene and healthy diets. Pain management training covers activity moderation and eliminating behaviors that cause pain. Family education and after-care assistance are provided.

Patients were identified as high risk if they had a history of using mood-al-tering substances, used pain medications in ways other than those prescribed, showed aberrant drug-related behaviors, had family members or health care providers who expressed concern, had a family history of substance abuse, or had other health risks (such as polypharmacy and high-dose opioid use). …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

CBT Helps High-Risk Patients Taper off Opioids
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.