Acceptance Therapy May Reduce Opioid Dependence in Patients

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The patients enrolled in a long-term pain management program at Toronto General Hospital.
The patients enrolled in a long-term pain management program at Toronto General Hospital.

HealthDay News — Teaching coping skills may help reduce the risk that patients with chronic pain will become addicted to opioids, according to research published in the Canadian Journal of Pain.

The study included 343 patients who developed chronic pain after major surgery. Many also had major depression and were taking high doses of opioids. The patients enrolled in a long-term pain management program at Toronto General Hospital. Those who were willing to taper off their opioids were referred to a clinical psychologist.

Instead of giving in to their pain, patients were encouraged to pursue meaningful life activities, become aware of the thoughts and feelings that accompany pain, and to accept difficult experiences such as pain. These skills, known as acceptance and commitment therapy, can be taught in 3 or 4 sessions. 

Over 2 years, they led to significant reductions in opioid use, depression, and pain-related disruptions of daily living, the researchers found.

"If we lower how many opioids patients are taking, but leave them disabled and not able to live their lives, that is not helpful," study coauthor Aliza Weinrib, PhD, a clinical psychologist at Toronto General Hospital, said in a hospital news release. "Patients can learn to respond to their pain in a different way, making it less overwhelming. They don't have to be so tied to their medications."

Reference

Azam MA, Weinrib AZ, Montbriand J, et al. Acceptance and commitment therapy to manage pain and opioid use after major surgery: Preliminary outcomes from the Toronto general hospital transitional pain service [published online June 28, 2017]. Can J Pain. doi:10.1080/24740527.2017.1325317

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