Objective
To study differences in treatment outcomes between patients with chronic noncancer
pain taking vs those not taking maintenance opioids at admission to a pain rehabilitation
program.
Patients and Methods
A nonrandomized 2-group prepost design was used to compare 356 patients admitted to
the Mayo Comprehensive Pain Rehabilitation Center from January 2002 to December 2002
at admission and discharge by opioid status at admission. Measures of pain severity,
interference due to pain, perceived life control, affective distress, activity level,
depression, and catastrophizing (an exaggerated negative mental set associated with
actual or anticipated pain experiences) were used to compare opioid and nonopioid
groups. The patients entered a 3-week intensive outpatient multidisciplinary pain
rehabilitation program designed to improve adaptation to chronic noncancer pain. The
program uses a cognitive-behavioral model and incorporates opioid withdrawal.
Results
More than one third of patients (135/356) were taking opioids daily at admission.
At completion of the program, all but 3 of the 135 patients had successfully discontinued
opioid treatment. No significant pretreatment differences were found between the opioid
and nonopioid group regarding demographics, pain duration, treatment completion, or
all outcome variables, including pain severity. Significant improvement was noted
at discharge for all outcome variables assessed regardless of opioid status at admission.
Conclusion
Patients with symptomatically severe and disabling pain while taking maintenance opioid
therapy can experience significant improvement in physical and emotional functioning
while participating in a pain rehabilitation program that incorporates opioid withdrawal.
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© 2004 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
