Targeting the Specialized Needs of Opioid-dependent and Pain Patients

Some addiction treatment facilities treating opioid addiction, sometimes complicated by concurrent severe pain, are finding that service quality can be improved in small-group treatment settings with a narrower focus on the opioid patient alone.

Some facilities have found it necessary to focus more sharply on the individualized needs of the patient dependent on heroin or prescription pain medication.

 

Site Conducive to MAT

By creating opioid-specific program and isolating opioid-dependent individuals from the rest of the patient population, some facilities believe they can work to reduce the duration of detox and do a better job of educating patients on the diverse treatment options available to them—including medication-assisted treatment (MAT), for example, using both buprenorphine and injectable naltrexone (Vivitrol) as part of treatment, in detox and for maintenance therapy in some cases.

These types of new programs often have a ceiling of the number of patients, with coed group sessions and other programming offered. Programs often are physically located close to the residential unit to which patients transition after detox.

Having individuals on MAT in a separate program also reduces the potential for diversion of medication to other patients. Suboxone is still used to a greater degree than other medication therapies in many treatment facilities because that is what most insurances cover.

 

Changing Response to Pain

These types of programs tend to rely heavily on reconditioning and cognitive-behavioral therapies to help people to experience less pain and to be more willing and able to lead functional lives.

Often, admitted patients who have opioid abuse problems rate their pain on average at a 7 on a 10-point scale. These program seek to get patients off opioids early on, which actually often helps with their pain, but do not take the approach that every patient must be 100% opioid-free upon leaving the program.

Some of the recent data from a group of nearly 100 patients show significant improvement following treatment and continuing care. A total of 80% of patients were found to be either off opioids or receiving agonist therapy at that point, while there was a 24% mean reduction in reported pain and more than a 50% decline in pain interference with activities and enjoyment of life.