Ramdin Christine, Attaalla Kyrillos, Ghafoor Naila, Nelson Lewis
From the Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, NJ.
J Addict Med. 2023;17(2):e72-e77. doi: 10.1097/ADM.0000000000001051. Epub 2022 Aug 17.
The rise in deaths related to substance use has caused a push toward linking patients to pharmacological maintenance treatment and, when appropriate, to residential substance use treatment facilities. One of the underlying issues in a subset of patients with substance use disorder (SUD) is chronic pain. We evaluated the prevalence and characteristics of those facilities that offer treatment programs tailored for patients with co-occurring pain and SUD.
This study was a retrospective review of data collected by the National Survey of Substance Abuse Treatment Services in 2019. The National Survey of Substance Abuse Treatment Services is sent annually to all substance use treatment facilities and collects information on their characteristics and services. We calculated prevalence of chronic pain programs, reported characteristics, and did a binomial logistic regression to determine predictors of a facility offering such a program.
Of 15,945 respondents, 2990 (18.8%) of facilities offered a tailored program for patients with co-occurring pain and SUDs. Characteristics that were best predictors included the following: facility has a tailored program for veterans ( P < 0.001), serves only clients with opioid use disorder ( P = 0.03), and provides maintenance services with methadone or buprenorphine for treating opioid use disorder ( P = 0.009).
As of 2019, only a small percentage of substance use treatment facilities reported having a program that treats patients with co-occurring pain and SUD. Given the known high prevalence of co-occurring pain and SUD, further understanding of the role of these programs and barriers to implementation may enhance acceptance in treatment programs.
与物质使用相关的死亡人数上升促使人们推动将患者与药物维持治疗联系起来，并在适当的时候与住院物质使用治疗设施联系起来。物质使用障碍（SUD）患者亚组中的一个潜在问题是慢性疼痛。我们评估了那些为同时患有疼痛和SUD的患者提供量身定制治疗方案的设施的患病率和特征。
本研究是对2019年全国药物滥用治疗服务调查收集的数据进行的回顾性分析。全国药物滥用治疗服务调查每年发送给所有物质使用治疗设施，并收集有关其特征和服务的信息。我们计算了慢性疼痛项目的患病率、报告的特征，并进行了二项式逻辑回归以确定提供此类项目的设施的预测因素。
在15945名受访者中，2990家（18.8%）设施为同时患有疼痛和SUD的患者提供了量身定制的项目。最佳预测因素包括以下特征：设施有为退伍军人量身定制的项目（P<0.001），仅为患有阿片类物质使用障碍的客户提供服务（P = 0.03），并提供美沙酮或丁丙诺啡维持服务以治疗阿片类物质使用障碍（P = 0.009）。
截至2019年，只有一小部分物质使用治疗设施报告有治疗同时患有疼痛和SUD患者的项目。鉴于已知同时患有疼痛和SUD的患病率很高，进一步了解这些项目的作用和实施障碍可能会提高治疗项目中的接受度。
