Chronic pain and comorbid mood and substance use disorders: A biopsychosocial treatment approach

2006 ◽  
Vol 8 (5) ◽  
pp. 371-376 ◽  
Author(s):  
Martin D. Cheatle ◽  
Rollin M. Gallagher
Keyword(s):  
Chronic Pain ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Treatment Approach

Risk classes of patients diagnosed with substance use disorders in Dutch forensic psychiatric centers

2021 ◽  
Vol 23 (1) ◽  
pp. 39-52
Author(s):  
Michele Schmitter ◽  
Jeroen Vermunt ◽  
Eric Blaauw ◽  
Stefan Bogaerts
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Latent Class ◽  
Mental Health Problems ◽  
Treatment Approach ◽  
Future Research ◽  
Content Type ◽  
Forensic Patients ◽  
Axis I ◽  
Forensic Psychiatric

Purpose Given the complex association between substance use disorders (SUD), comorbid mental health problems and criminal recidivism in forensic patients, homogenous patient classes can contribute to a refined treatment. This paper aims to construct those classes in forensic patients (N = 286) diagnosed with SUD, unconditionally released between 2004 and 2013 of one of ten Dutch forensic psychiatric centers. Design/methodology/approach Retrospective data were derived from electronic patient files. Classes were based on the Dutch risk assessment tool, the Historisch Klinisch Toekomst-Revisie (Historical Clinical Future–Revised [HKT-R]) and identified by means of explorative Latent Class Analysis in Latent Gold version 5.1. In a three-step approach, posterior class memberships were related to external variables (i.e. diagnoses, type of drug and type of offence). Findings Four classes were identified that differ in the risk of recidivism, as well as Axis I and II diagnoses and type of drug consumption. Practical implications This study informed on the heterogeneity of forensic patients with SUD and identified four homogenous classes that differ in important variables for the treatment approach. Based on these classes, a more refined treatment approach can be developed. Possible treatment approaches are discussed, but future research is needed to provide evidence. Originality/value This study is the first to identify classes within forensic patients with SUD and, therefore, sets the first step to develop a tailored treatment approach based on characteristics informative for treatment.

Associations between Childhood Abuse and Chronic Pain in Adults with Substance Use Disorders

2020 ◽  
pp. 1-6
Author(s):  
Nadine R. Taghian ◽  
R. Kathryn McHugh ◽  
Margaret L. Griffin ◽  
Alexandra R. Chase ◽  
Shelly F. Greenfield ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Substance Use ◽  
Childhood Abuse ◽  
Substance Use Disorders

Treatment of Substance Use Disorders

2019 ◽  
pp. 38-53
Author(s):  
Dennis C. Daley ◽  
Antoine Douaihy
Keyword(s):  
Substance Use ◽  
Family Therapy ◽  
Case Management ◽  
Substance Use Disorders ◽  
Treatment Approach ◽  
Treatment Programs ◽  
Individual Group ◽  
Community Recovery ◽  
Medical Evaluation

People do not respond the same way to any one particular treatment approach in any particular setting. Some need more intensive and/or extensive treatment than others. It is not unusual for a person with a severe SUD to engage in several episodes of treatment before sustaining recovery. For those who are physically addicted, medical detoxification may be needed before they can benefit from other types of treatment. Treatment is helpful only to the extent that a person sticks with it and uses the guidance of professionals and peers in recovery. The person with an SUD may use any combination of treatment programs, services, or community recovery supports. Treatment includes detoxification; rehabilitation; individual, group, and family therapy; other services (case management, vocational or leisure counseling, medical evaluation); and medications.

scholarly journals Negative Affect–Related Factors Have the Strongest Association with Prescription Opioid Misuse in a Cross-Sectional Cohort of Patients with Chronic Pain

Pain Medicine ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. e127-e138 ◽  
Author(s):  
Gadi Gilam ◽  
John A Sturgeon ◽  
Dokyoung S You ◽  
Ajay D Wasan ◽  
Beth D Darnall ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Substance Use ◽  
Negative Affect ◽  
Substance Use Disorders ◽  
Opioid Misuse ◽  
Related Factors ◽  
Opioid Prescription ◽  
Increased Risk ◽  
Patient Reported ◽  
Opioid Medications

Abstract Objective Increased opioid prescription to relieve pain among patients with chronic pain is associated with increased risk for misuse, potentially leading to substance use disorders and overdose death. We aimed to characterize the relative importance and identify the most significant of several potential risk factors for the severity of self-reported prescribed opioid misuse behaviors. Methods A sample of 1,193 patients (mean age ± SD = 50.72 ± 14.97 years, 64.04% female) with various chronic pain conditions completed a multidimensional registry assessing four pain severity measures and 14 physical, mental, and social health status factors using the National Institutes of Health’s Patient-Reported Outcomes Measurement Information System (PROMIS). A validated PROMIS measure of medication misuse was completed by 692 patients who endorsed currently taking opioid medication. Patients taking opioid medications were compared across all measures with those who do not take opioid medications. Subsequently, a data-driven regression analysis was used to determine which measures best explained variability in severity of misuse. We hypothesized that negative affect–related factors, namely anxiety, anger, and/or depression, would be key predictors of misuse severity due to their crucial role in chronic pain and substance use disorders. Results Patients taking opioid medications had significantly greater impairment across most measures. Above and beyond demographic variables, the only and most significant predictors of prescribed opioid misuse severity were as follows: anxiety (β = 0.15, P = 0.01), anger (β = 0.13, P = 0.02), Pain Intensity–worst (β = 0.09, P = 0.02), and depression (β = 0.13, P = 0.04). Conclusions Findings suggest that anxiety, anger, and depression are key factors associated with prescribed opioid misuse tendencies in patients with chronic pain and that they are potential targets for therapeutic intervention.

scholarly journals Efficacy of a Psychosocial Pain Management Intervention for Men and Women With Substance Use Disorders and Chronic Pain

2020 ◽  
Vol 77 (12) ◽  
pp. 1225
Author(s):  
Mark A. Ilgen ◽  
Lara N. Coughlin ◽  
Amy S. B. Bohnert ◽  
Stephen Chermack ◽  
Amanda Price ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Substance Use ◽  
Pain Management ◽  
Substance Use Disorders ◽  
Men And Women ◽  
Management Intervention

scholarly journals Attitudinal Barriers to Analgesic Use among Patients with Substance Use Disorders

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Leah Zallman ◽  
Sonia L. Rubens ◽  
Richard Saitz ◽  
Jeffrey H. Samet ◽  
Christine Lloyd-Travaglini ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Substance Use ◽  
Side Effects ◽  
Substance Use Disorders ◽  
Opioid Use ◽  
Attitudinal Barriers ◽  
Primary Care Patients ◽  
Opioid Use Disorders ◽  
Analgesic Use

Attitudinal barriers towards analgesic use among primary care patients with chronic pain and substance use disorders (SUDs) are not well understood. We evaluated the prevalence of moderate to significant attitudinal barriers to analgesic use among 597 primary care patients with chronic pain and current analgesic use with 3 subscales from the Barriers Questionaire II: concern about side effects, fear of addiction, and worry about reporting pain to physicians. Concern about side effects was a greater barrier for those with opioid use disorders (OUDs) and non-opioid SUDs than for those with no SUD (OR (95% CI): 2.30 (1.44–3.68), P<0.001 and 1.64 (1.02–2.65), P=0.041, resp.). Fear of addiction was a greater barrier for those with OUDs as compared to those with non-opioid SUDs (OR (95% CI): 2.12 (1.04–4.30), P=0.038) and no SUD (OR (95% CI): 2.69 (1.44–5.03), P=0.002). Conversely, participants with non-opioid SUDs reported lower levels of worry about reporting pain to physicians than those with no SUD (OR (95% CI): 0.43 (0.24–0.76), P=0.004). Participants with OUDs reported higher levels of worry about reporting pain than those with non-opioid SUDs (OR (95% CI): 1.91 (1.01–3.60), P=0.045). Concerns about side effects and fear of addiction can be barriers to analgesic use, moreso for people with SUDs and OUDs.

Sign in / Sign up

Export Citation Format

Share Document