The Impact of Chronic Pain on Opioid Use Disorder Treatment Outcomes

Abstract

Chronic pain among individuals diagnosed with opioid use disorder (OUD) receiving opioid agonist treatment (OAT) is common. We review extant literature on the impact of chronic pain on OAT outcomes (i.e., illicit opioid use and OAT retention). We found 13 manuscripts using 9 datasets. The relationship between chronic pain and OAT outcomes is mixed. Most studies reported no relationship between chronic pain and illicit opioid use, but definitions of chronic pain were inconsistent. There was some evidence that chronic pain is associated with higher likelihood of drug use, and associations with retention were rarely reported. OAT clinics should thoughtfully assess pain at intake and regularly assess pain intensity and interference. Repeated assessments during daily life offer some advantages, and there is a need for nonpharmacologic pain treatments that complement OAT clinical care. These may require additional resources for OAT clinics to effectively address pain.