(150) Short-Term Outcomes following an Intensive Outpatient Program for Patients with Comorbid Substance Use Disorder and Chronic Pain at Walter Reed National Military Medical Center (WRNMMC)

Abstract

Research suggests a high comorbidity between chronic pain and substance use disorder (SUD), particularly within a military population. Optimal clinical treatment for those with chronic pain and SUD is believed to be multidisciplinary care. However, limited research has been conducted on this topic within the military health care system (MHS). This quality improvement project examines short-term outcomes for a joint-SUD and chronic pain intensive outpatient program (IOP). Active duty, veterans, and dependents were enrolled in a 6-week Joint-IOP at WRNMMC. The multidisciplinary team included addiction social workers, physical therapists, nurses, and clinical psychologists. Patients received a breathalyzer and urine drug screen at the time of treatment initiation and periodically throughout. Participants filled out the following validated questionnaires pre- and post-treatment: Defense and Veterans Pain Rating Scale (DVPRS), Pain Outcomes Questionnaire (POQ), Brief Addiction Monitor (BAM), World Health Organization Quality of Life-Brief (WHOQOL-BREF) and Pain Catastrophizing Scale (PCS). Fifty-eight patients completed the joint-IOP. Paired T-tests suggest a reduction in DVPRS worst pain scores (p=0.013), reduced POQ total impairment (p=0.034) and improved POQ vitality (p=0.024) from pre- to post-treatment. Paired T-tests suggest a trend toward decreased alcohol and substance use as measured by the BAM (p=0.056). Both WHO quality of life and pain catastrophizing showed no significant change. This project suggests that patients suffering from chronic pain and SUD within the MHS have improved pain and SUD outcomes at the completion of a 6-week joint-IOP. Implications of this project suggest the importance of concurrently treating chronic pain and SUD within the MHS.