Ameral Victoria, Hickey Thomas R, Reilly Erin Dawna, Patterson Jessica A, Sofuoglu Mehmet
VISN 1 Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, USA.
Department of Psychiatry, UMass Chan Medical School, Worcester, MA, USA.
Expert Opin Pharmacother. 2025 Jun;26(9):1041-1054. doi: 10.1080/14656566.2025.2506688. Epub 2025 May 17.
A critical challenge in providing effective medical care for individuals in opioid agonist treatment (OAT) for opioid use disorder is the effective management of acute and chronic pain. While pain commonly co-occurs with opioid use disorder, there is limited research to guide effective management of pain in this population.
We first provide an overview of the etiology and treatment of acute and chronic pain, highlighting areas of complexity for patients receiving OAT. We then describe the search strategy, which involved a date-inclusive search for relevant terms in PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. After summarizing the results of this search on the evidence for pharmacological and behavioral treatments of acute and chronic pain for individuals on OAT, we conclude with a discussion of these findings and a summarized expert opinion on the state of the evidence.
The evidence suggests that while research on effective treatment of acute and chronic pain in individuals in OAT is limited, promising work is ongoing to translate existing treatments, particularly behavioral treatments for chronic pain, to support this population. However, further research is warranted, particularly regarding pharmacological options.
为接受阿片类激动剂治疗（OAT）以治疗阿片类药物使用障碍的个体提供有效医疗护理的一项关键挑战是对急性和慢性疼痛进行有效管理。虽然疼痛通常与阿片类药物使用障碍同时出现，但指导该人群疼痛有效管理的研究有限。
我们首先概述急性和慢性疼痛的病因及治疗方法，重点强调接受OAT治疗的患者所面临的复杂领域。然后我们描述检索策略，该策略涉及在PubMed、EMBASE和Cochrane对照试验中央登记库中对相关术语进行含日期的检索。在总结此次检索关于OAT个体急性和慢性疼痛的药物及行为治疗证据的结果后，我们以对这些发现的讨论以及对证据状况的专家意见总结作为结尾。
证据表明，虽然关于OAT个体急性和慢性疼痛有效治疗的研究有限，但正在进行有前景的工作，以转化现有治疗方法，特别是慢性疼痛的行为治疗方法，来支持这一人群。然而，有必要进行进一步研究，尤其是在药物选择方面。
