(530) Suboxone decreases the odds of opioid resumption in patients with opioid addiction following treatment in a chronic pain rehabilitation program including opioid weaning

Abstract

Patients weaned from opioid within an interdisciplinary chronic pain rehabilitation program (CPRP) show improvements in improve pain and function. Patients with chronic non-cancer pain (CNCP) and comorbid opioid addiction also face potential relapse. Suboxone has been demonstrated to decrease the odds of opioid relapse; however, little research has examined it’s use in a CPRP. This retrospective study compared 12 month treatment outcomes of patients with opioid addiction discharged on Suboxone for with patients with opioid addiction who were opioid weaned. 30 patients were discharged on Suboxone between 2007-2012. Cases were matched in age and gender, resulting in a total n of 60. Participants were predominately married (56.7%, n=34) males (n=39, 65.0%) with a mean age of 42.55 (±12.49). Both groups were equally likely to have a lifetime history of a substance use disorder (63.3%, n=38, χ2=.86, 1, ns) and there was no difference between the two in mean morphine equivalence dosage at admission (M=280.28±300.42). Pain and function ratings were collected at admission, discharge and 12 months post-treatment and opioid resumption at 12 months. Repeated measures MANOVA indicated participants reported improvements in pain (p<.01) and function (p<.01) from admission to discharge and sustained improvement at 12 months (p<.01). There were no between-group differences. At 12 months, opioid resumption data was available for 28 opioid weaned and 24 Suboxone patients. 38.5% of patients had resumed opioid use, with weaned patients more likely to resume (χ2=4.74, 1, p<.05). 50% of weaned patients resumed opioid use: 6 resumed chronic opioid therapy and 8 found opioid cravings unmanageable (4 initiated Suboxone and 4 relapsed). 5 Suboxone patients (20.83%) had used opioids; all had relapsed. Findings show that patients with pain and comorbid addiction benefit from CPRP treatment in terms of pain and function and treatment with Suboxone decreases the odds of resumption of other opioids. Patients weaned from opioid within an interdisciplinary chronic pain rehabilitation program (CPRP) show improvements in improve pain and function. Patients with chronic non-cancer pain (CNCP) and comorbid opioid addiction also face potential relapse. Suboxone has been demonstrated to decrease the odds of opioid relapse; however, little research has examined it’s use in a CPRP. This retrospective study compared 12 month treatment outcomes of patients with opioid addiction discharged on Suboxone for with patients with opioid addiction who were opioid weaned. 30 patients were discharged on Suboxone between 2007-2012. Cases were matched in age and gender, resulting in a total n of 60. Participants were predominately married (56.7%, n=34) males (n=39, 65.0%) with a mean age of 42.55 (±12.49). Both groups were equally likely to have a lifetime history of a substance use disorder (63.3%, n=38, χ2=.86, 1, ns) and there was no difference between the two in mean morphine equivalence dosage at admission (M=280.28±300.42). Pain and function ratings were collected at admission, discharge and 12 months post-treatment and opioid resumption at 12 months. Repeated measures MANOVA indicated participants reported improvements in pain (p<.01) and function (p<.01) from admission to discharge and sustained improvement at 12 months (p<.01). There were no between-group differences. At 12 months, opioid resumption data was available for 28 opioid weaned and 24 Suboxone patients. 38.5% of patients had resumed opioid use, with weaned patients more likely to resume (χ2=4.74, 1, p<.05). 50% of weaned patients resumed opioid use: 6 resumed chronic opioid therapy and 8 found opioid cravings unmanageable (4 initiated Suboxone and 4 relapsed). 5 Suboxone patients (20.83%) had used opioids; all had relapsed. Findings show that patients with pain and comorbid addiction benefit from CPRP treatment in terms of pain and function and treatment with Suboxone decreases the odds of resumption of other opioids.