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Impact of Opioid Use on Outcomes of Functional Restoration

MacLaren, Jill E. MA*; Gross, Richard T. PhD; Sperry, Jeannie A. PhD; Boggess, Jeffrey T. PhD

The Clinical Journal of Pain: May 2006 - Volume 22 - Issue 4 - p 392-398
doi: 10.1097/01.ajp.0000208250.15572.01
Original Articles
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Objectives To examine the effect of opioid use on psychological function, physical functioning, and return-to-work outcomes of a multidisciplinary rehabilitation program (MRP) for chronic pain.

Methods The participants were 127 patients with on-the-job injuries who had completed an MRP between 2001 and 2003. Opioid use was controlled by the patients' treating physicians (who were not affiliated with the MRP) and was assessed via patient self-report at the time of admission to the program and discharge. Other measures included pretreatment and posttreatment assessments of depression, pain severity, perceived disability, and physical ability (floor-to-waist lifting capacity). Return-to-work outcomes were obtained via follow-up phone calls approximately 6 months posttreatment.

Results Significant improvements from pretreatment to posttreatment were evidenced on all psychological and physical measures for both opioid users and nonusers. Further, there were no significant posttreatment differences between opioid and nonopioid users on psychological, physical, or return-to-work outcomes.

Discussion The role of opioids in the treatment of chronic pain continues to be controversial. Despite a lack of definitive data on their effectiveness, opioids continue to be prescribed, and thus patients using opioids continue to present for multidisciplinary rehabilitation. Although further exploration is warranted, results of the current study suggest that opioid use during rehabilitation does not necessarily preclude treatment success.

*Department of Psychology, West Virginia University, Morgantown, WV

Oasis Occupational Rehabilitation, Morgantown, WV

Reprints: Richard T. Gross, PhD, Oasis Occupational Rehabilitation, Morgantown, WV (e-mail: rtgoasis@psimedinc.com).

Received for publication April 9, 2005;; revised July 23, 2005 and September 12, 2005; accepted September 14, 2005

© 2006 Lippincott Williams & Wilkins, Inc.