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Use of Conventional, Complementary, and Alternative Treatments for Pain Among Individuals Seeking Primary Care Treatment With Buprenorphine-Naloxone

Barry, Declan T. PhD; Savant, Jonathan D. BS; Beitel, Mark PhD; Cutter, Christopher J. PhD; Moore, Brent A. PhD; Schottenfeld, Richard S. MD; Fiellin, David A. MD

doi: 10.1097/ADM.0b013e31826d1df3
Original Research

Previous studies have not examined patterns of pain treatment use among patients seeking office-based buprenorphine-naloxone treatment (BNT) for opioid dependence.

Objectives: To examine, among individuals with pain seeking BNT for opioid dependence, the use of pain treatment modalities, perceived efficacy of prior pain treatment, and interest in pursuing pain treatment while in BNT.

Methods: A total of 244 patients seeking office-based BNT for opioid dependence completed measures of demographics, pain status (ie, “chronic pain (CP)” [pain lasting at least 3 months] vs “some pain (SP)” [pain in the past week not meeting the duration criteria for chronic pain]), pain treatment use, perceived efficacy of prior pain treatment, and interest in receiving pain treatment while in BNT.

Results: In comparison with the SP group (N = 87), the CP group (N = 88) was more likely to report past-week medical use of opioid medication (adjusted odds ratio [AOR] = 3.2; 95% CI, 1.2–8.4), lifetime medical use of nonopioid prescribed medication (AOR = 2.2; 95% CI, 1.1–4.7), and lifetime use of prayer (AOR = 2.8; 95% CI, 1.2–6.5) and was less likely to report lifetime use of yoga (AOR = 0.2; 95% CI, 0.1–0.7) to treat pain. Although the 2 pain groups did not differ on levels of perceived efficacy of prior lifetime pain treatments, in comparison with the SP group, the CP group was more likely to report interest in receiving pain treatment while in BNT (P < 0.001).

Conclusions: Individuals with pain seeking BNT for opioid dependence report a wide range of conventional, complementary, and alternative pain-related treatments and are interested (especially those with CP) in receiving pain management services along with BNT.

From the Yale University School of Medicine, New Haven, CT (DTB, MB, CJC, BAM, RSS, DAF) and The APT Foundation Pain Treatment Services, New Haven, CT (DTB, JDS, MB, CJC).

Send correspondence and reprint requests to Declan T. Barry, PhD, Yale University School of Medicine, CMHC/SAC Room 220, 34 Park Street, New Haven, CT 06519. E-mail:

This research was supported in part by funding from the National Institute on Drug Abuse to Dr Barry (K23 DA024050), Dr Moore (K01 DA022398), Dr Schottenfeld (K24 DA000445, R01DA024695), and Dr Fiellin (R01 DA019511, RO1 DA020576). Dr Fiellin has received honoraria for serving on external advisory boards monitoring diversion and abuse of buprenorphine from Pinney Associates and ParagonRx. None of the other authors are affiliated with the tobacco, alcohol, pharmaceutical, or gambling industry in a manner that we believe represents a conflict of interest with the current manuscript.

Received March 29, 2012

Accepted August 02, 2012

© 2012 American Society of Addiction Medicine