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Association of Chronic Noncancer Pain With Substance Abuse Treatment Outcomes Among a Community Mental Health Center Sample

Stevenson, Erin PhD, MSW; Cole, Jennifer PhD; Walker, Robert LCSW; Logan, TK PhD

Addictive Disorders & Their Treatment: March 2014 - Volume 13 - Issue 1 - p 30–37
doi: 10.1097/ADT.0b013e31827b0cd9
Original Articles

Objectives: The purpose of this study is to examine the association of chronic noncancer pain (CNCP) with substance abuse treatment outcomes as measured by illicit drug use, unemployment, and arrests 12 months after an intake assessment.

Methods: The sample included 1196 adults from 14 community-based substance abuse treatment programs that incorporated residential, outpatient, case management, and intensive outpatient services. Within the sample, 226 individuals reported the occurrence of CNCP at both treatment intake and 12-month follow-up. Binomial logistic regression analyses were used to examine substance abuse treatment outcomes comparing cases with CNCP (n=226) to cases without CNCP (n=970). As mental health confounds both CNCP and substance abuse treatment issues, baseline covariates were used to control for self-reported depression and anxiety in the models.

Results: Individuals in the sample at intake who were older, of white race, who reported past 12-month anxiety symptoms, use of illicit drugs, and who were unemployed, retired, or disabled were more likely to report CNCP. Binary logistic regression models indicate that within this sample, CNCP was associated with continued illicit drug use at 12-month follow-up, but not with arrests or unemployment status at follow-up.

Conclusions: The higher rates of illicit drug use at intake and continued drug use at follow-up for individuals with CNCP may indicate the need for specific pain management assistance. Recommendations include providing standard CNCP screening and assessment as part of substance abuse treatment protocols along with resource referrals.

Department of Behavioral Sciences, College of Medicine, Center on Drug & Alcohol Research, Lexington, KY

Supported by a contract between the Kentucky Department of Behavioral Health, Division for Behavioral Health, Developmental, and Intellectual Disabilities and the University of Kentucky Center on Drug & Alcohol Research.

The authors declare no conflict of interest.

Reprints: Erin Stevenson, PhD, MSW, University of Kentucky Center on Drug & Alcohol Research, 333 Waller Avenue, Ste. 480, Lexington, KY 40504 (e-mail:

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