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The current state of knowledge on care for co-occurring chronic pain and opioid use disorder: A scoping review.

Journal of clinical nursing
August 1, 2024
Léonie Archambault et al. (6 authors)
Journal ArticleScoping ReviewHuman Study
Study Details

Study Goal

The researchers aimed to identify current treatments and delivery models for co-occurring chronic pain and opioid use disorder (OUD), including the effectiveness of Mindfulness-Oriented Recovery Enhancement.

Results Summary

The study found that combining opioid agonist treatments (OAT) with Mindfulness-Oriented Recovery Enhancement or cognitive behavioral therapy showed effectiveness in managing co-occurring chronic pain and OUD. Authors generally recommended a combination of strategies to address patient needs.

Population

Individuals with co-occurring chronic pain and opioid use disorder (OUD).

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (9)
InterventionDirectionEndpointPopulationDosageImpactClaim #
opioid agonist treatments (OAT) such as methadone or buprenorphine/naloxone
increase
co-occurring chronic pain and opioid use disorder (OUD) management
-
-
provide evidence for the effectiveness
#1
combining OAT with Mindfulness-Oriented Recovery Enhancement
increase
co-occurring chronic pain and opioid use disorder (OUD) management
-
-
provide evidence for the effectiveness
#2
combining OAT with cognitive behavioural therapy
increase
co-occurring chronic pain and opioid use disorder (OUD) management
-
-
provide evidence for the effectiveness
#3
other pharmacological treatments (opioid and nonopioid)
neutral
co-occurring chronic pain and opioid use disorder (OUD) management
-
-
are also underlined
#4
nonpharmacological treatments (e.g. physiotherapy)
neutral
co-occurring chronic pain and opioid use disorder (OUD) management
-
-
are also underlined
#5
service delivery models (e.g. simultaneous treatment of comorbidities, interdisciplinary and interprofessional collaboration)
neutral
co-occurring chronic pain and opioid use disorder (OUD) management
-
-
are also underlined
#6
a combination of strategies
increase
patient needs
-
-
authors recommend
#7
integrated treatment of the multiple biopsychosocial dimensions of the co-occurring disorders
increase
co-occurring chronic pain and OUD
-
-
experts recommend the uptake
#8
collaborative interdisciplinary work
increase
co-occurring chronic pain and OUD
-
-
experts recommend the uptake
#9
Abstract

BACKGROUND AND AIMS: Opioid use disorder often co-occurs with chronic pain but assessment and treatment of these co-occurring disorders is complex. This review aims to identify current treatments and delivery models for co-occurring chronic pain and opioid use disorder (OUD) documented in the scientific literature. DESIGN: Scoping review. METHODS: The review was conducted in six databases in June 2022 (no time limit): CINAHL, PsycINFO, Web of Science, Cochrane, PubMed and Embase. The PRISMA-ScR checklist was used to guide reporting. RESULTS: Forty-seven publications addressing the issue of co-occurring chronic pain and OUD management were included. Randomized controlled trials provide evidence for the effectiveness of opioid agonist treatments (OAT) such as methadone or buprenorphine/naloxone, as well as for combining OAT with Mindfulness-Oriented Recovery Enhancement or cognitive behavioural therapy. A number of other pharmacological treatments (opioid and nonopioid), nonpharmacological treatments (e.g. physiotherapy) and service delivery models (e.g. simultaneous treatment of comorbidities, interdisciplinary and interprofessional collaboration) are also underlined. In most cases, authors recommend a combination of strategies to meet patient needs. CONCLUSIONS: The scoping review reveals gaps in evidence-based knowledge to effectively care for co-occurring chronic pain and OUD, but several experts recommend the uptake of known 'best' practices such as integrated treatment of the multiple biopsychosocial dimensions of the co-occurring disorders as well as collaborative interdisciplinary work. CLINICAL RELEVANCE: Improving services is dependent on alleviating barriers such as working in silos, the costs associated with nonpharmacological treatments, and the double stigma associated with pain in people with a substance use disorder.

Medical Subject Headings (MeSH)
HumansChronic PainOpioid-Related DisordersAnalgesics, OpioidPain ManagementOpiate Substitution Treatment
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality80/10
Citation Metrics
Total Citations4
Citations/Year4.0
Research Impact Scores
APT Score0.75
Weight Score2.82
Normalized Score0.66
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