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Drug Alcohol Depend. 2015 Apr 1;149:285-9. doi: 10.1016/j.drugalcdep.2015.02.007. Epub 2015 Feb 17.

Longitudinal analysis of pain and illicit drug use behaviors in outpatients on methadone maintenance.

Author information

1
MJHS Institute for Innovation in Palliative Care, 39 Broadway, 12th Floor, New York, NY 10006, USA. Electronic address: LDhingra@mjhs.org.
2
Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, First Avenue at 16th Street, New York, NY 10003, USA; Department of Medicine, Mount Sinai Beth Israel, First Avenue at 16th Street, New York, NY 10003, USA; Center for Drug Use and HIV Research, New York University, 726 Broadway, New York, NY 10003, USA.
3
Department of Psychiatry, University of California at San Francisco, 1001 Potrero Avenue, San Francisco, CA 94110, USA.
4
MJHS Institute for Innovation in Palliative Care, 39 Broadway, 12th Floor, New York, NY 10006, USA.
5
Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, First Avenue at 16th Street, New York, NY 10003, USA; Center for Drug Use and HIV Research, New York University, 726 Broadway, New York, NY 10003, USA.
6
Consult-Stat: Complete Statistical Services, 5754 Loyola Street, Macungie, PA 18062, USA.
7
MJHS Institute for Innovation in Palliative Care, 39 Broadway, 12th Floor, New York, NY 10006, USA; Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
8
Center for Studies of Addiction, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Reading Health System, West Reading, PA 19611, USA.

Abstract

BACKGROUND:

Little is known about the experience of chronic pain and the occurrence of illicit drug use behaviors in the population enrolled in methadone maintenance treatment (MMT) programs.

METHODS:

This is a secondary analysis of longitudinal data from two MMT samples enrolled in a randomized controlled trial of hepatitis care coordination. Patients completed pain, illicit drug use, and other questionnaires at baseline and 3, 9, and 12 months later. Associations were sought over time between the presence or absence of clinically significant pain (average daily pain ≥ 4 or mean pain interference ≥ 4 during the past week) and current illicit drug use (i.e., non-therapeutic opioid, cocaine or amphetamine use identified from self-report or urine drug screening).

RESULTS:

Of 404 patients providing complete data, within-patient variability in pain and illicit drug use was high across the four assessment periods. While 263 denied pain at baseline, 118 (44.9%) later experienced clinically significant pain during ≥ 1 follow-up assessments. Of 180 patients (44.6%) without evidence of illicit drug use at baseline, only 109 (27.0%) had similar negative drug use at all follow-up assessments. Across four assessment periods, there was no significant association between pain group status and current illicit drug use.

CONCLUSIONS:

This one-year longitudinal analysis did not identify a significant association between pain and illicit drug use in MMT populations. This finding conflicts with some earlier investigations and underscores the need for additional studies to clarify the complex association between pain and substance use disorders in patients in MMT program settings.

KEYWORDS:

Addiction; Illicit drug use; Methadone maintenance; Pain; Pain management

PMID:
25735466
PMCID:
PMC4391061
DOI:
10.1016/j.drugalcdep.2015.02.007
[Indexed for MEDLINE]
Free PMC Article

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