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Opioid cessation and chronic pain

perspectives of former opioid users

Goesling, Jennaa,*; DeJonckheere, Melissab; Pierce, Jennifera; Williams, David A.a; Brummett, Chad M.a; Hassett, Afton L.a; Clauw, Daniel J.a

doi: 10.1097/j.pain.0000000000001493
Research Paper
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Current guidelines for addressing opioid cessation in the context of chronic pain management recommend that opioids be discontinued if the risks outweigh the benefits. However, few studies have focused on understanding opioid cessation from the perspective of individuals with chronic pain. This mixed-method study included 49 former opioid users with chronic pain and used quantitative survey data and qualitative focus group data to identify themes pertaining to former opioid user's experience before, during, and after opioid cessation. Participants described several reasons for wanting to stop opioids including lack of efficacy, impact on quality of life, and concerns about addiction. Barriers to cessation included concerns about inadequate pain management and concerns about the impact of stopping opioids on mood. After opioid cessation, the sample was mixed regarding the benefit of cessation. Half of the former opioid users reported their pain to be better or the same after stopping opioids; however, 47% of the sample reported feeling worse pain since stopping their opioids. As the pendulum swings from pain control to drug control, we must ensure that the response to the opioid epidemic does not cause harm to individuals with chronic pain. Novel opioid cessation interventions are needed in combination with methods of addressing individual challenges and barriers to adequate pain relief including access to and provision of nonopioid alternatives for pain management.

Since stopping opioids, half of the participants report their pain has improved or stayed the same, and half report worse pain after opioid cessation.

Departments of aAnesthesiology and

bFamily Medicine, University of Michigan, Ann Arbor, MI, United States

Corresponding author. Address: Department of Anesthesiology, University of Michigan, Back and Pain Center Burlington Building 1, Suite 100, 325 E. Eisenhower Pkwy, Ann Arbor, MI, 48108, United States. Tel.: 734-998-0456. E-mail address: jennagoe@med.umich.edu (J. Goesling).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Received September 23, 2018

Received in revised form December 23, 2018

Accepted January 02, 2019

© 2019 International Association for the Study of Pain
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