2024
Editorial for the themed issue: Addressing the dual challenges of opioid use disorder and chronic pain in the context of the opioid crisis
Sofuoglu M, MacLean R, De Aquino J. Editorial for the themed issue: Addressing the dual challenges of opioid use disorder and chronic pain in the context of the opioid crisis. British Journal Of Clinical Pharmacology 2024, 90: 2960-2961. PMID: 39340184, PMCID: PMC11604519, DOI: 10.1111/bcp.16273.Peer-Reviewed Original ResearchFrom taboo to treatment: The emergence of psychedelics in the management of pain and opioid use disorder
Weleff J, Nunes J, Costa G, Sofuoglu M, MacLean R, De Aquino J. From taboo to treatment: The emergence of psychedelics in the management of pain and opioid use disorder. British Journal Of Clinical Pharmacology 2024 PMID: 38627909, PMCID: PMC11480258, DOI: 10.1111/bcp.16045.Peer-Reviewed Original ResearchOpioid use disorderChronic painLong-term opioid therapyManagement of chronic painPain management alternativeOpioid-induced analgesiaInnovative treatment optionsManagement of painReverse painCentral sensitizationOpioid therapyPain controlTreatment optionsClinical challengeClinical trialsPainPotential therapeutic applicationsPain experiencePotential of psychedelicsNovel therapeuticsHuman evidenceOpioid crisisNeurobiological substratesOpioidExploration of novel therapeutics
2023
Are opioids effective analgesics and is physiological opioid dependence benign? Revising current assumptions to effectively manage long‐term opioid therapy and its deprescribing
Manhapra A, MacLean R, Rosenheck R, Becker W. Are opioids effective analgesics and is physiological opioid dependence benign? Revising current assumptions to effectively manage long‐term opioid therapy and its deprescribing. British Journal Of Clinical Pharmacology 2023, 90: 2962-2976. PMID: 37990580, PMCID: PMC11563311, DOI: 10.1111/bcp.15972.Peer-Reviewed Original ResearchLong-term opioid therapyOpioid therapyFunctional gainsChronic pain syndromeMaximum functional recoveryOngoing opioid crisisParadoxical worseningAnalgesic benefitAnalgesic therapyPain reliefPain syndromeEffective analgesicMost patientsAntinociceptive effectAntinociceptive systemChronic painFunctional recoveryOpioid actionOpioid dependenceMedical instabilityFunctional improvementPlacebo effectClinical principlesOpioid crisisTherapeutic inductionChronic pain and problematic substance use for veterans during COVID-19: the moderating role of psychological flexibility
Reilly E, Wolkowicz N, Heapy A, MacLean R, Duarte B, Chamberlin E, Harris J, Shirk S, Kelly M. Chronic pain and problematic substance use for veterans during COVID-19: the moderating role of psychological flexibility. Frontiers In Psychology 2023, 14: 1173641. PMID: 37205082, PMCID: PMC10185850, DOI: 10.3389/fpsyg.2023.1173641.Peer-Reviewed Original ResearchQuality of lifeProblematic substance useChronic painMental health functioningSubstance useHealth functioningCOVID-19Mental healthChronic pain diagnosesBetter mental health functioningPsychological flexibilityU.S. veteran populationPain severityComorbid conditionsPain diagnosisClinical managementPainBetter outcomesVeteran populationCertain veteransPhysical healthGreater psychological flexibilityShort ScreenerEmotional healthVeteransIntegrating cognitive bias modification for pain and opioid cues into medication for opioid use disorder clinical care: Feasibility, acceptability, and preliminary results
MacLean R, Heapy A, Waters A, Wolkowicz N, Szollosy S, Meyerovich J, Sofuoglu M. Integrating cognitive bias modification for pain and opioid cues into medication for opioid use disorder clinical care: Feasibility, acceptability, and preliminary results. Drug And Alcohol Dependence 2023, 246: 109857. PMID: 37004461, PMCID: PMC10189744, DOI: 10.1016/j.drugalcdep.2023.109857.Peer-Reviewed Original ResearchConceptsTrial-level bias scoresOpioid cuesAB taskCognitive bias modification taskAttentional bias taskCognitive bias modificationComputer-based tasksPreliminary efficacyOpioid use disorderCurrent studyBias modificationBias taskBias scoresModification tasksCBM groupCBM tasksChronic painAcceptability measuresControl conditionTaskUse disordersClinical careCuesTime interactionParticipantsOpioid Use Disorder With Chronic Pain Increases Disease Burden and Service Use
MacLean RR, Sofuoglu M, Stefanovics E, Rosenheck R. Opioid Use Disorder With Chronic Pain Increases Disease Burden and Service Use. Psychological Services 2023, 20: 157-165. PMID: 34968125, PMCID: PMC9358616, DOI: 10.1037/ser0000607.Peer-Reviewed Original ResearchConceptsOpioid use disorderChronic painMental health diagnosesService useUse disordersHealth AdministrationConcurrent opioid use disorderHealth diagnosisOngoing opioid epidemicOutpatient service useVeterans Health AdministrationMental health disordersSubstance use diagnosesSingle disorder groupsClinical service useOpioid prescriptionsAdditional comorbiditiesMultinomial regression analysisDisease burdenMedication fillsOpioid epidemicPrescription opiatesMedical conditionsMedical disordersUse diagnoses
2022
Pre‐implementation formative evaluation of cooperative pain education and self‐management expanding treatment for real‐world access: A pragmatic pain trial
Mattocks K, LaChappelle K, Krein S, DeBar L, Martino S, Edmond S, Ankawi B, MacLean R, Higgins D, Murphy J, Cooper E, Heapy A. Pre‐implementation formative evaluation of cooperative pain education and self‐management expanding treatment for real‐world access: A pragmatic pain trial. Pain Practice 2022, 23: 338-348. PMID: 36527287, DOI: 10.1111/papr.13195.Peer-Reviewed Original ResearchConceptsCBT-CPChronic painPragmatic trialOngoing pragmatic trialVeterans Affairs sitesPrimary care cliniciansPragmatic clinical trialsVA Medical CenterEvidence-based treatmentsSystem-level factorsReal-world accessCognitive behavioral therapyPain intensityPain trialsCare cliniciansReferral pathwaysPain educationClinicians' lackClinical trialsMedical CenterSystem barriersQualitative interviewsReal-world settingIndividual qualitative interviewsClinicians' difficultyUsing Daily Ratings to Examine Treatment Dose and Response in Cognitive Behavioral Therapy for Chronic Pain: A Secondary Analysis of the Co-Operative Pain Education and Self-Management Clinical Trial
MacLean R, Buta E, Higgins D, Driscoll M, Edmond S, LaChappelle K, Ankawi B, Krein S, Piette J, Heapy A. Using Daily Ratings to Examine Treatment Dose and Response in Cognitive Behavioral Therapy for Chronic Pain: A Secondary Analysis of the Co-Operative Pain Education and Self-Management Clinical Trial. Pain Medicine 2022, 24: 846-854. PMID: 36484691, PMCID: PMC10250557, DOI: 10.1093/pm/pnac192.Peer-Reviewed Original ResearchConceptsPain intensityCognitive behavioral therapyCBT-CPChronic painTreatment responseDaily stepsSecondary analysisBehavioral therapyMeaningful changeChronic back painStrong evidence baseBack painPain educationTreatment weekClinical trialsNoninferiority trialTreatment benefitOutcome measuresWeek 4Treatment doseWeek 2Baseline weekMost respondersSurvival analysisStep countAdherence to Daily Interactive Voice Response Calls for a Chronic Pain Intervention
Ankawi B, Piette J, Buta E, Edmond S, MacLean R, Higgins D, LaChappelle K, Krein S, Heapy A. Adherence to Daily Interactive Voice Response Calls for a Chronic Pain Intervention. Journal Of Technology In Behavioral Science 2022, 7: 343-350. DOI: 10.1007/s41347-022-00254-6.Peer-Reviewed Original ResearchChronic painCBT-CPIVR callsIntervention groupLong-term opioid treatmentChronic pain interventionsFirst-line treatmentNon-pharmacological managementNon-pharmacological interventionsCognitive behavioral therapyBaseline cognitive functioningOpioid treatmentBaseline characteristicsPain interventionsAdherence ratesPatient subgroupsTelehealth deliveryClinical trialsTreatment protocolPerson treatmentTreatment efficacyPainSecondary analysisDaily Interactive Voice ResponsePatients
2021
Chronic Pain, Dietary Intake and Exercise Behaviors in a Nationally Representative Sample of US Adults
Vernarelli J, MacLean R. Chronic Pain, Dietary Intake and Exercise Behaviors in a Nationally Representative Sample of US Adults. Current Developments In Nutrition 2021, 5: 1101. PMCID: PMC8180694, DOI: 10.1093/cdn/nzab053_094.Peer-Reviewed Original ResearchChronic painUS adultsDietary intakeDietary patternsTotal fatDietary pattern differencesOverall fat intakeChronic pain statusDietary intake patternsHistory of painPhysical activity dataRepresentative sampleCycles of NHANESComplex survey designInflammatory markersPain locationPain statusNationally Representative SampleDietary interventionPain assessmentCurrent painExamination visitsFat intakeMusculoskeletal healthLow intakeThe Impact of Chronic Pain on Opioid Use Disorder Treatment Outcomes
MacLean R, Spinola S, Garcia-Vassallo G, Sofuoglu M. The Impact of Chronic Pain on Opioid Use Disorder Treatment Outcomes. Current Addiction Reports 2021, 8: 100-108. DOI: 10.1007/s40429-020-00352-6.Peer-Reviewed Original ResearchOpioid agonist treatmentChronic painOpioid use disorderOpioid Use Disorder Treatment OutcomesNonpharmacologic pain treatmentsIllicit opioid useDisorder treatment outcomesReviewChronic painOpioid usePain intensityPain treatmentAgonist treatmentOAT clinicsTreatment outcomesClinical carePainUse disordersDrug useRecent FindingsWeHigher likelihoodClinicOutcomesTreatmentMost studiesIntake
2020
Co-Operative Pain Education and Self-management (COPES) Expanding Treatment for Real-World Access (ExTRA): Pragmatic Trial Protocol
Heapy AA, Driscoll MA, Buta E, LaChappelle KM, Edmond S, Krein SL, Piette JD, Mattocks K, Murphy JL, DeBar L, MacLean RR, Ankawi B, Kawecki T, Martino S, Wagner T, Higgins DM. Co-Operative Pain Education and Self-management (COPES) Expanding Treatment for Real-World Access (ExTRA): Pragmatic Trial Protocol. Pain Medicine 2020, 21: s21-s28. PMID: 33313733, PMCID: PMC7734659, DOI: 10.1093/pm/pnaa365.Peer-Reviewed Original ResearchConceptsCBT-CPMusculoskeletal painPragmatic trialInteractive voice responseHealth care system factorsPragmatic trial protocolChronic musculoskeletal painVA Medical CenterVeterans Affairs cliniciansDepression symptom severityBudget impact analysisReal-world accessCognitive behavioral therapySecondary outcomesPain intensityPrimary outcomeChronic painPain interferenceSuperiority trialGlobal ImpressionPain educationPatient preferencesTrial protocolMedical CenterReal-world settingComplex Persistent Opioid Dependence with Long-term Opioids: a Gray Area That Needs Definition, Better Understanding, Treatment Guidance, and Policy Changes
Manhapra A, Sullivan MD, Ballantyne JC, MacLean RR, Becker WC. Complex Persistent Opioid Dependence with Long-term Opioids: a Gray Area That Needs Definition, Better Understanding, Treatment Guidance, and Policy Changes. Journal Of General Internal Medicine 2020, 35: 964-971. PMID: 33159241, PMCID: PMC7728942, DOI: 10.1007/s11606-020-06251-w.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyOpioid taperingOpioid dependenceChronic pain refractoryUtilization of buprenorphineLong-term opioidsSevere chronic painOpioid use disorderMultitude of treatmentsLimited supportive evidenceOpioid therapyPain refractoryBuprenorphine treatmentChronic painClinical instabilityRecent guidelinesClinical definitionUS adultsUse disordersDiagnosis/Treatment guidancePainComplicationsTreatmentSupportive evidencePredictors of engagement in an internet-based cognitive behavioral therapy program for veterans with chronic low back pain
Solar C, Halat AM, MacLean RR, Rajeevan H, Williams DA, Krein SL, Heapy AA, Bair MJ, Kerns RD, Higgins DM. Predictors of engagement in an internet-based cognitive behavioral therapy program for veterans with chronic low back pain. Translational Behavioral Medicine 2020, 11: 1274-1282. PMID: 33098304, DOI: 10.1093/tbm/ibaa098.Peer-Reviewed Original ResearchConceptsChronic low back painLow back painClinical characteristicsBack painChronic painEASE programParticipant characteristicsInternet-based cognitive behavioural therapy programmeInternet-based cognitive behavioral therapy interventionInternet-based interventionsCognitive behavioral therapy interventionInternet-based programCognitive behavioral therapy programBehavioral therapy interventionBehavioral therapy programRace/ethnicityPain careMean ageNumber of loginsIncreased ageTherapy interventionWeek trialPainTherapy programPredictors of engagement
2019
Systematic Review of Pain Severity and Opioid Craving in Chronic Pain and Opioid Use Disorder
MacLean RR, Spinola S, Manhapra A, Sofuoglu M. Systematic Review of Pain Severity and Opioid Craving in Chronic Pain and Opioid Use Disorder. Pain Medicine 2019, 21: e146-e163. PMID: 32034413, DOI: 10.1093/pm/pnz228.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyOpioid use disorderChronic painPain severityOpioid therapyOpioid cravingUse disordersEligible studiesSystematic reviewOpioid use disorder patientsChronic pain populationsRisk of biasInclusion/exclusion criteriaPain populationObservational studyExclusion criteriaPainDisorder patientsPsycINFO databasesTherapyMean levelsDisordersSeverityStudy of individualsCraving