2024
Screening, brief intervention, and referral to treatment for pain management for veterans separating from military service: study protocol of a hybrid type 2 study testing implementation facilitation versus training-as-usual
Sellinger J, Rosen M, Lazar C, Gilstad-Hayden K, Dziura J, Li F, Mattocks K, Weede A, Sullivan-Tibbs M, Rose L, Vassallo G, Manhapra A, Turner A, Vogt D, Woodward E, Hartmann C, Haskell S, Mohammad A, Martino S. Screening, brief intervention, and referral to treatment for pain management for veterans separating from military service: study protocol of a hybrid type 2 study testing implementation facilitation versus training-as-usual. Pain Medicine 2024, 25: s99-s106. PMID: 39514877, DOI: 10.1093/pm/pnae062.Peer-Reviewed Original ResearchConceptsTraining-as-usualImplementation facilitatorsReferral to treatmentCase managementBrief interventionHybrid type 2 effectiveness-implementation trialPain managementImplementation strategiesPrimary implementation outcomeSubstance misuseProportion of participantsPain careUsefulness of screeningVeteran engagementVA sitesImplementation outcomesPragmatic trialPain serviceVeteran participantsCase management systemPain intensityDischarged veteransStudy enrollmentVeteransChronic painPotential Role for Buprenorphine in the Management of Comorbid Depression Among People with Chronic Pain and Long-Term Opioid Therapy Dependence
Manhapra A, Rosenheck R, Becker W. Potential Role for Buprenorphine in the Management of Comorbid Depression Among People with Chronic Pain and Long-Term Opioid Therapy Dependence. 2024, 148-164. DOI: 10.1093/9780197675250.003.0009.Peer-Reviewed Original ResearchLong-term opioid therapyKappa-opioid receptorsChronic painOpioid receptorsKappa-opioid receptor antagonismManagement of comorbid depressionTherapeutic agentsMOR agonismOpioid therapyOpioid taperAntidepressant effectsWorsening painOpioid dependenceSafety profileAgonist actionPoor outcomeClinical trialsAssociated with worsening depressionPainEtiological driversBuprenorphineReceptor affinityComorbid depressionOpioidReceptorsThe Impact of Non-Pain Factors on Pain Interference Among U.S. Service Members and Veterans with Symptoms of Mild Traumatic Brain Injury
Kennedy E, Manhapra A, Miles S, Martindale S, Rowland J, Mobasher H, Myers M, Panahi S, Walker W, Pugh M. The Impact of Non-Pain Factors on Pain Interference Among U.S. Service Members and Veterans with Symptoms of Mild Traumatic Brain Injury. Journal Of Neurotrauma 2024 PMID: 38907690, DOI: 10.1089/neu.2024.0126.Peer-Reviewed Original ResearchPredictors of pain interferencePain interferenceMild traumatic brain injuryTraumatic brain injuryU.S. service membersPain intensityAssociated with pain interferenceAssociated with functional limitationsService membersRates of traumatic brain injuryPain interference scoresPain intensity scoresHistory of traumatic brain injuryProspective longitudinal observational studyNon-pain symptomsTraumatic brain injury historyLongitudinal observational studyHolistic treatment approachSymptoms of mild traumatic brain injuryBrain injuryFunctional limitationsPain scoresChronic painIdentifying fatigueTargeting comorbidities
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 inductionIs psychiatric diagnostic remission associated with reduced prevalence of moderate to severe pain interference and improved functioning among adults with lifetime psychiatric disorders?
Manhapra A, Zhou B, Rhee T, Rosenheck R. Is psychiatric diagnostic remission associated with reduced prevalence of moderate to severe pain interference and improved functioning among adults with lifetime psychiatric disorders? Journal Of Affective Disorders 2023, 344: 585-591. PMID: 37863364, DOI: 10.1016/j.jad.2023.10.094.Peer-Reviewed Original ResearchConceptsLifetime psychiatric disordersPast-year psychiatric disordersSevere pain interferencePain interferencePsychiatric disordersPD remissionChronic painNon-substance use psychiatric disordersPrevalence of painMental functioningLower physical functioningNational Epidemiologic SurveyRelated Conditions-IIIPoor mental functioningCommon comorbiditiesPhysical functionAdjusted oddsPhysical functioningObservational studyReduced prevalenceRemissionUS adultsDiagnostic remissionEpidemiologic SurveyPainPain Management in Older Adults Before and During the First Year of COVID-19 Pandemic: Prevalence, Trends, and Correlates
Manhapra A, Fortinsky R, Berg K, Ross J, Rhee T. Pain Management in Older Adults Before and During the First Year of COVID-19 Pandemic: Prevalence, Trends, and Correlates. The Journals Of Gerontology Series A 2023, 78: 1627-1640. PMID: 37096328, PMCID: PMC10460550, DOI: 10.1093/gerona/glad115.Peer-Reviewed Original ResearchConceptsHigh-impact chronic painChronic painPain managementOlder adultsCoronavirus diseasePain treatmentNational Health Interview SurveyNonpharmacological pain treatmentsUtilization of opioidsHealth Interview SurveyUS older adultsFirst yearOpioid useNonpharmacological treatmentsNonpharmacological interventionsTreatment utilizationLong-term effectsPainU.S. adultsPrevalenceInterview SurveyDiseaseAdultsCOVID-19 pandemicTreatment
2020
Association of symptom severity, pain and other behavioral and medical comorbidities with diverse measures of functioning among adults with post-traumatic stress disorder
Manhapra A, Stefanovics EA, Rhee TG, Rosenheck RA. Association of symptom severity, pain and other behavioral and medical comorbidities with diverse measures of functioning among adults with post-traumatic stress disorder. Journal Of Psychiatric Research 2020, 134: 113-120. PMID: 33383494, DOI: 10.1016/j.jpsychires.2020.12.063.Peer-Reviewed Original ResearchConceptsMental health composite scoresPhysical function scoresPost-traumatic stress disorderSubstance use disordersMedical comorbiditiesPain interferencePTSD symptomsStatistical Manual-5 (DSM-5) criteriaSymptom severityMental health-related qualityStress disorderPast-year post-traumatic stress disorderShort Form-12Health-related qualityNational Epidemiologic SurveyNegative associationCommon comorbiditiesChronic painForm-12Medical illnessSubstantial disabilityPsychiatric comorbidityPTSD symptom severityFunction scoresIndependent associationComplex 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 evidence
2019
Prescribing, Prescription Monitoring, and Health Policy
Gordon A, Cochran G, Smid M, Manhapra A, Kertesz S. Prescribing, Prescription Monitoring, and Health Policy. Current Clinical Psychiatry 2019, 223-238. DOI: 10.1007/978-3-030-16257-3_11.Peer-Reviewed Original ResearchOpioid use disorderPrescription drug monitoring programsUse disordersOpioid prescribingOpioid prescriptionsOpioid useOpioid misuseClinical interventionsOpioid-related harmsPrescription opioid useDrug monitoring programsOpioid-related morbidityOpioid addiction epidemicUnited States CentersTreatment of personsPrescribing opioidsChronic painIllicit opioidsCDC guidelinesMedication treatmentPrescription monitoringOpioid epidemicHealth of communitiesAddiction epidemicDisease controlSystematic 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
2018
The Conundrum of Opioid Tapering in Long-Term Opioid Therapy for Chronic Pain: A Commentary
Manhapra A, Arias A, Ballantyne J. The Conundrum of Opioid Tapering in Long-Term Opioid Therapy for Chronic Pain: A Commentary. Substance Use & Addiction Journal 2018, 39: 152-161. PMID: 28929914, PMCID: PMC6129223, DOI: 10.1080/08897077.2017.1381663.Peer-Reviewed Original ResearchConceptsLong-term opioid therapyOpioid taperingChronic painOpioid therapyOpioid dependencePsychiatric symptomsHigher-dose long-term opioid therapyClinical scenariosPoor pain controlTerm opioid therapyUse of opioidsDifficult clinical scenariosUnique clinical challengesOpioid needsPain controlNeuroplasticity effectsAbstinence syndromeFunctional statusOpioid epidemicClinical challengeFunctional declinePainAffective symptomsPsychiatric instabilityAvailable evidence