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Study Suggests Role for Targeting Psychological Variables in the Treatment of Opioid Use Disorder and Chronic Pain

October 28, 2019

There is a paucity of evidence-based treatments for co-occurring opioid use disorder and chronic pain. These inter-related chronic medical conditions have been central to the unfolding of the opioid crisis. A new study by researchers at Yale, Johns Hopkins, University of Bridgeport, and Western Connecticut State University published in the Journal of Clinical Psychology suggests that psychological variables are important treatment targets for co-occurring opioid use disorder and chronic pain.

The psychological variables of interest were pain catastrophizing and pain acceptance. Pain catastrophizing is a thinking error characterized by magnification of pain, helplessness, and rumination, and is an important focus of cognitive-behavioral therapy (CBT). Pain acceptance refers to the extent to which individuals are willing to stay with pain and engage in meaningful activities despite their pain, and is an important focus of acceptance and commitment therapy (ACT). CBT and ACT are evidence-based treatments for chronic pain but have not been systematically examined in patients with co-occurring opioid use disorder and chronic pain.

A study of 134 adult patients with pain at the APT Foundation who were receiving methadone treatment for opioid use disorder found that pain catastrophizing and pain acceptance independently predicted both pain severity and interference in functioning attributable to pain (i.e., pain interference).

"These new findings are noteworthy since they offer support for the potential usefulness of CBT and ACT for patients with opioid use disorder and chronic pain," said Declan T. Barry, PhD, Associate Professor of Psychiatry and in the Child Study Center at Yale School of Medicine. Barry was the study's senior author.

The authors concluded that these new findings underscore that “both pain catastrophizing and pain acceptance are potentially important pain intervention targets among patients who have co-occurring opioid use disorder and pain.”

Barry noted, "In the search for treatment approaches for co-occurring opioid use disorder and chronic pain, researchers should consider testing psychological and other non-pharmacological approaches in addition to medications  for opioid use disorder.”

Chung Jung Mun, PhD, from Johns Hopkins School of Medicine was the study's first author. Yale-affiliated co-authors were Mark Beitel, PhD (Department of Psychiatry and Child Study Center), and Lynn M. Madden, PhD (Department of Internal Medicine-AIDS).

Other co-authors included Lindsay M. Oberleitner, PhD (Western Connecticut State University, Department of Psychology) and David E. Oberleitner, PhD (University of Bridgeport, Department of Psychology).




Submitted by Christopher Gardner on October 28, 2019