Multidisciplinary Approach to Opioid Reduction Can Achieve Dosage Goals

MAY 10, 2013
Katie Eder
In light of issues concerning opioid misuse and dependence running parallel to the tenfold increase of prescription opioid use over the past 20 years, a team of researchers have developed an ongoing study examining results of a pilot program aimed at reducing patients’ use of pain medications.
For their “A multidisciplinary outpatient pain management opioid reduction pilot program” study, Patricia Tsui, PhD, a clinical psychologist at the Center for Pain Management at Stony Brook, in Stony Brook, NY, and colleagues reviewed the medical charts and medication histories of seven patients enrolled in a pain medication safety class at an academic multidisciplinary outpatient pain management center. The participants — most of whom had chronic back pain with overlapping or multiple pain conditions — were either self-referred or referred by their physicians to the opioid reduction program, “thus, some patients were actively trying to reduce opioid consumption, but some were not,” the authors wrote.
Aside from the pain medication safety class, opioid reduction strategies executed in the study included involvement in mental health services, such as psychiatry and psychotherapy, as well as “improved patient-provider communication, such as more honesty and insight with regards to pain medication use to help guide treatment plans,” according to the authors.
Thus far, three of the participants have reduced their opioid use, and after converting pain medications to their morphine equivalents, end dosages ranged from 0 milligrams to 30 milligrams per day, compared to the starting dosages range from 22.5 milligrams to 270 milligrams per day. At an author-attended poster session at the 32nd Annual Scientific Meeting of the American Pain Society, Tsui said participants who were actively attempting to reduce their pain medications had a mean reduction of 105 milligrams per day while maintaining fairly stable pain levels. On the flip side, patients who were not trying to reduce their opioid medications had a mean increase of 0.28 milligrams per day.

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