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Psychosocial interventions for chronic pain and comorbid prescription opioid use disorders: A narrative review of the literature.

Journal of opioid management
January 1, 2018
Valerie Hruschak et al. (3 authors)
Journal ArticleSystematic ReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the literature on psychosocial interventions, including mindfulness-based therapies, for chronic noncancer pain (CNCP) and prescription opioid misuse.

Results Summary

The review found that mindfulness-based cognitive therapy and mindfulness-based stress reduction were among the interventions studied for CNCP, but little empirical data were available to guide practitioners on their effectiveness for opioid misuse. The findings reinforced the importance of psychosocial interventions but highlighted the need for more research on integrated approaches.

Population

Individuals with chronic noncancer pain and/or prescription opioid misuse.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (10)
InterventionDirectionEndpointPopulationDosageImpactClaim #
psychosocial interventions
neutral
chronic noncancer pain (CNCP) and prescription opioid misuse
patients with CNCP who misuse opioid medications
-
targeting
#1
cognitive behavioral therapy (CBT)
neutral
chronic noncancer pain (CNCP)
patients with CNCP
-
examined for
#2
acceptance and commitment therapy
neutral
chronic noncancer pain (CNCP)
patients with CNCP
-
examined for
#3
mindfulness-based cognitive therapy
neutral
chronic noncancer pain (CNCP)
patients with CNCP
-
examined for
#4
mindfulness-based stress reduction
neutral
chronic noncancer pain (CNCP)
patients with CNCP
-
examined for
#5
chronic pain self-management programs
neutral
chronic noncancer pain (CNCP)
patients with CNCP
-
examined for
#6
cognitive behavioral therapy (CBT) and relapse prevention
neutral
opioid misuse
patients with opioid use disorders
-
included for
#7
motivational enhancement therapy and stages of change
neutral
opioid misuse
patients with opioid use disorders
-
included for
#8
contingency management
neutral
opioid misuse
patients with opioid use disorders
-
included for
#9
self-help and peer support-based groups
neutral
opioid misuse
patients with opioid use disorders
-
included for
#10
Abstract

OBJECTIVE: Opioid misuse in the context of chronic noncancer pain (CNCP) is a multifaceted and complex issue. As opioid misuse and corresponding rates of addiction and overdose deaths exceed epidemic proportions, there is an urgent need for research in this area. The objective of this review is to evaluate the literature addressing psychosocial interventions targeting CNCP and prescription opioid misuse. DESIGN: A systematic search of PubMed, MEDLINE, PsychINFO, ClinicalTrials.gov was conducted to identify studies evaluating psychosocial interventions targeting CNCP and prescription opioid misuse. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: 56 peer-reviewed research articles from 1993 to July, 2016, which included studies of psychosocial interventions for CNCP and opioid use disorders. Studies that examined psychosocial interventions for CNCP, treatment modalities included: cognitive behavioral therapy (CBT), acceptance and commitment therapy, mindfulness-based cognitive therapy and mindfulness-based stress reduction, and chronic pain self-management programs. The psychosocial interventions for opioid misuse included: CBT and relapse prevention, motivational enhancement therapy and stages of change, contingency management, and self-help and peer support-based groups. CONCLUSIONS: The findings of this review offer clinical insight and reinforce the importance of psychosocial interventions in CNCP and opioid use disorders. However, little empirical data are available to guide practitioners in treating patients with CNCP who misuse opioid medications, and thus future research on integrated approaches, is needed.

Medical Subject Headings (MeSH)
Analgesics, OpioidChronic PainComorbidityHumansOpioid-Related DisordersPrescription DrugsPsychotherapyRisk FactorsSubstance-Related DisordersTreatment Outcome
Study Links
Quality Scores
SafetyNot Assessed
Efficacy70/10
Quality80/10
Citation Metrics
Total Citations13
Citations/Year1.9
Relative Citation Ratio0.84
NIH Percentile43.9%
Research Impact Scores
APT Score0.75
Weight Score2.06
Normalized Score0.64
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