Study Finds Chronic Pain Associated with Substance Abuse After Detox
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(Boston, MA) – Researchers at Boston University School of Medicine (BUSM) and the New England Research Institutes in Watertown, Mass., have found that among individuals leaving residential detoxification programs, chronic pain is a common problem and is associated independently with long-term substance use after detoxification. These findings were published in the March 6 on-line edition of Addiction (May print edition).
A high prevalence of pain has been reported in cross-sectional studies of patients with drug use including those from methadone programs and short-term residential treatment programs. Inadequate pain treatment is a particularly challenging problem among these patients due to the concern that opiates for treating pain may contribute to exacerbation of the substance abuse.
The researchers studied 397 adults who had completed a residential detoxification program for alcohol, heroin or cocaine. The majority of subjects (55 percent) reported moderate or severe pain at study entry. Persistent pain 24 months after detoxification was observed in 16 percent of subjects and intermittent pain in 54 percent of subjects. Persistent pain was associated with increased probability of return to heroin use and heavy alcohol use after detoxification.
According to the researchers, the implication of this study is that clinicians and researchers should pay additional attention to managing chronic pain with individuals with substance dependence.
“The findings that persistent pain among people with substance use disorders is associated with recurrent alcohol and opioid use suggest clinical approaches that could potentially enhance the effectiveness of substance use services,” said study director Jeffrey Samet, MD, MPH, a professor of medicine at BUSM.
“Treatment center, detoxification program and primary care physicians should be aware of pain problems and seek adequate care for patients with moderate to very severe pain,” adds Mary Jo Larson, PhD, Principal Research Scientist at New England Research Institutes and lead author.
The National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse provided support for this study.