Wiest K., Colditz J.B., McCarty D., & Pilkonis P.A. (June 2011). PROMIS pain scales and addiction treatment patients. Poster presentation in Montreal, QC: 3rd North American Congress of Epidemiology.
Abstract: Patients with substance use disorders have relatively high complaints of pain, anxiety and depression during treatment. Individuals receiving methadone maintenance for opioid dependence often report even greater levels of pain. Little is known about pain status at the beginning of treatment. The National Institutes of Health’s (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) reliably and validly measures health outcomes using computer-assisted testing and scales developed with item response theory. PROMIS scales were used to explore pain symptoms and emotional distress among participants (n = 407) within the first 30 days of beginning methadone (n = 171) and outpatient (n = 236) substance use treatment. Clinical participants were recruited from substance use treatment programs in Portland, Oregon (n = 182), Seattle, Washington (n = 115) and Pittsburgh, Pennsylvania (n = 115) from March through October 2010. The comparison group (n = 1000) completed study measures through the YouGov Polimetrix internet panel. Study participation required respondents to report at least one alcoholic drink in the 30 days prior to completing the survey. Analyses adjusted for age and race. Mean pain interference, anxiety, fatigue and depression scores were significantly higher in substance use treatment patients. Patients receiving methadone maintenance were 3.5 times (p < .001) more likely to report severe pain interference relative to the comparison group. Obesity (body mass index > 30.0) was not associated with increased pain. Incorporating treatment practices directed to patients with pain interference and related distress may enhance treatment efficacy for patients with substance use disorders.