Development and Preliminary Evaluation of an Integrated Cognitive-Behavior Treatment for Chronic Pain and Substance Use Disorder in Patients with the Hepatitis C Virus

Benjamin Morasco, David W. Greaves, Travis Lovejoy, Dennis C. Turk, Steven Dobscha, Peter Hauser

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

OBJECTIVE: Individuals with the hepatitis C virus (HCV) have high rates of both chronic pain and substance use disorder (SUD). Despite high comorbidity, there are limited data available on effective methods of treatment for co-occurring chronic pain and SUD. In this study, we sought to develop and conduct preliminary testing of an integrated cognitive-behavior therapy (CBT) for chronic pain and SUD in patients with HCV.

DESIGN: Descriptive, including pretreatment, posttreatment, and follow-up testing.

SETTING AND PATIENTS: Outpatient clinic as part of one VA Medical Center.

PARTICIPANTS: Veterans with chronic pain, SUD, and HCV.

INTERVENTION: Eight-session integrated group CBT for chronic pain and SUD in patients with HCV.

METHODS: Participants completed standardized measures of pain, function, depression severity, and alcohol and substance use at baseline, post-treatment, and 3-month follow-up.

RESULTS: Generalized estimating equations identified improvements in pain interference, reducing cravings for alcohol and other substances, and decreasing past-month alcohol and substance use. The proportion of participants who met diagnostic criteria for current SUD demonstrated a four-fold decrease over the course of the study from 24% at baseline to 15% at post-treatment and 6% at 3-month follow-up. On response to a global impression of change, 94% of participants noted improvement from baseline.

CONCLUSIONS: Results from this pilot study suggest that a customized CBT for patients with both chronic pain and SUD (CBT-cp.sud) may be beneficial in improving important pain and addiction-related outcomes in patients with HCV. Larger scale investigations of this intervention appear warranted.

Original languageEnglish (US)
Pages (from-to)2280-2290
Number of pages11
JournalPain medicine (Malden, Mass.)
Volume17
Issue number12
DOIs
StatePublished - Dec 1 2016

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Chronic Pain
Hepacivirus
Substance-Related Disorders
Cognitive Therapy
Alcohols
Pain
Therapeutics
Veterans
Ambulatory Care Facilities
Comorbidity
Depression

Keywords

  • Chronic Pain
  • Cognitive-Behavior Therapy
  • Hepatitis C Virus
  • Integrated Treatment
  • Substance Use Disorder

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

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title = "Development and Preliminary Evaluation of an Integrated Cognitive-Behavior Treatment for Chronic Pain and Substance Use Disorder in Patients with the Hepatitis C Virus",
abstract = "OBJECTIVE: Individuals with the hepatitis C virus (HCV) have high rates of both chronic pain and substance use disorder (SUD). Despite high comorbidity, there are limited data available on effective methods of treatment for co-occurring chronic pain and SUD. In this study, we sought to develop and conduct preliminary testing of an integrated cognitive-behavior therapy (CBT) for chronic pain and SUD in patients with HCV.DESIGN: Descriptive, including pretreatment, posttreatment, and follow-up testing.SETTING AND PATIENTS: Outpatient clinic as part of one VA Medical Center.PARTICIPANTS: Veterans with chronic pain, SUD, and HCV.INTERVENTION: Eight-session integrated group CBT for chronic pain and SUD in patients with HCV.METHODS: Participants completed standardized measures of pain, function, depression severity, and alcohol and substance use at baseline, post-treatment, and 3-month follow-up.RESULTS: Generalized estimating equations identified improvements in pain interference, reducing cravings for alcohol and other substances, and decreasing past-month alcohol and substance use. The proportion of participants who met diagnostic criteria for current SUD demonstrated a four-fold decrease over the course of the study from 24{\%} at baseline to 15{\%} at post-treatment and 6{\%} at 3-month follow-up. On response to a global impression of change, 94{\%} of participants noted improvement from baseline.CONCLUSIONS: Results from this pilot study suggest that a customized CBT for patients with both chronic pain and SUD (CBT-cp.sud) may be beneficial in improving important pain and addiction-related outcomes in patients with HCV. Larger scale investigations of this intervention appear warranted.",
keywords = "Chronic Pain, Cognitive-Behavior Therapy, Hepatitis C Virus, Integrated Treatment, Substance Use Disorder",
author = "Benjamin Morasco and Greaves, {David W.} and Travis Lovejoy and Turk, {Dennis C.} and Steven Dobscha and Peter Hauser",
year = "2016",
month = "12",
day = "1",
doi = "10.1093/pm/pnw076",
language = "English (US)",
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pages = "2280--2290",
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TY - JOUR

T1 - Development and Preliminary Evaluation of an Integrated Cognitive-Behavior Treatment for Chronic Pain and Substance Use Disorder in Patients with the Hepatitis C Virus

AU - Morasco, Benjamin

AU - Greaves, David W.

AU - Lovejoy, Travis

AU - Turk, Dennis C.

AU - Dobscha, Steven

AU - Hauser, Peter

PY - 2016/12/1

Y1 - 2016/12/1

N2 - OBJECTIVE: Individuals with the hepatitis C virus (HCV) have high rates of both chronic pain and substance use disorder (SUD). Despite high comorbidity, there are limited data available on effective methods of treatment for co-occurring chronic pain and SUD. In this study, we sought to develop and conduct preliminary testing of an integrated cognitive-behavior therapy (CBT) for chronic pain and SUD in patients with HCV.DESIGN: Descriptive, including pretreatment, posttreatment, and follow-up testing.SETTING AND PATIENTS: Outpatient clinic as part of one VA Medical Center.PARTICIPANTS: Veterans with chronic pain, SUD, and HCV.INTERVENTION: Eight-session integrated group CBT for chronic pain and SUD in patients with HCV.METHODS: Participants completed standardized measures of pain, function, depression severity, and alcohol and substance use at baseline, post-treatment, and 3-month follow-up.RESULTS: Generalized estimating equations identified improvements in pain interference, reducing cravings for alcohol and other substances, and decreasing past-month alcohol and substance use. The proportion of participants who met diagnostic criteria for current SUD demonstrated a four-fold decrease over the course of the study from 24% at baseline to 15% at post-treatment and 6% at 3-month follow-up. On response to a global impression of change, 94% of participants noted improvement from baseline.CONCLUSIONS: Results from this pilot study suggest that a customized CBT for patients with both chronic pain and SUD (CBT-cp.sud) may be beneficial in improving important pain and addiction-related outcomes in patients with HCV. Larger scale investigations of this intervention appear warranted.

AB - OBJECTIVE: Individuals with the hepatitis C virus (HCV) have high rates of both chronic pain and substance use disorder (SUD). Despite high comorbidity, there are limited data available on effective methods of treatment for co-occurring chronic pain and SUD. In this study, we sought to develop and conduct preliminary testing of an integrated cognitive-behavior therapy (CBT) for chronic pain and SUD in patients with HCV.DESIGN: Descriptive, including pretreatment, posttreatment, and follow-up testing.SETTING AND PATIENTS: Outpatient clinic as part of one VA Medical Center.PARTICIPANTS: Veterans with chronic pain, SUD, and HCV.INTERVENTION: Eight-session integrated group CBT for chronic pain and SUD in patients with HCV.METHODS: Participants completed standardized measures of pain, function, depression severity, and alcohol and substance use at baseline, post-treatment, and 3-month follow-up.RESULTS: Generalized estimating equations identified improvements in pain interference, reducing cravings for alcohol and other substances, and decreasing past-month alcohol and substance use. The proportion of participants who met diagnostic criteria for current SUD demonstrated a four-fold decrease over the course of the study from 24% at baseline to 15% at post-treatment and 6% at 3-month follow-up. On response to a global impression of change, 94% of participants noted improvement from baseline.CONCLUSIONS: Results from this pilot study suggest that a customized CBT for patients with both chronic pain and SUD (CBT-cp.sud) may be beneficial in improving important pain and addiction-related outcomes in patients with HCV. Larger scale investigations of this intervention appear warranted.

KW - Chronic Pain

KW - Cognitive-Behavior Therapy

KW - Hepatitis C Virus

KW - Integrated Treatment

KW - Substance Use Disorder

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JO - Pain Medicine

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SN - 1526-2375

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