Treatment Approaches for Patients With Opioid Use Disorder and Chronic Noncancer Pain: a Literature Review

Abstract

Background: 

The comorbidity between opioid use disorder and chronic noncancer pain (CNCP) create a challenge for clinicians involved in the care of those patients. Our goal in this review is to offer guidelines for treating this comorbidity based on a systematic literature review.

Methods: 

We performed a literature review. Thirty-two studies were selected for the review based on specific inclusion criteria. We created a data extraction form to collect data from each study and to increase the reliability of data collection.

Results: 

We identified aberrant behavior associated with opioid misuse. Some studies found aberrant behaviors to be strongly associated with opioid use disorder. Eight studies investigated the utilization of buprenorphine and methadone for treatment of comorbid opioid use disorder and CNCP. Two studies investigated the utilization of mindfulness and cognitive behavioral therapy for patients with comorbid opioid use disorder and CNCP.

Conclusions: 

Buprenorphine and methadone seem to be good options for treatment of patients with comorbid opioid addiction and CNCP. The current evidence is promising but is based on limited observational and pilot studies. There are currently very limited studies that showed promising results for using mindfulness and cognitive behavioral therapy for patients with opioid misuse and CNCP.