Pain and emotional distress among substance-use patients beginning treatment relative to a representative comparison group

Wiest K., Colditz J.B., Carr K., Asphaug V., McCarty D., & Pilkonis P.A. (2014). Pain and emotional distress among substance-use patients beginning treatment relative to a representative comparison group. Journal of Addiction Medicine, 8(6), 407-414. doi: 10.1097/ADM.0000000000000072


Objectives: A secondary analysis assessed health-related quality-of-life (HRQOL) characteristics (ie, anxiety, depression, fatigue, and types of pain) among patients entering substance-use treatment and identified characteristics specific to treatment modalities relative to a representative comparison group.

Methods: As part of a larger alcohol bank assessment, substance-use patients (n = 406) beginning methadone treatment (n = 170) or other outpatient treatment (n = 236) and a comparison group representative of the general population (n = 1000) completed a survey measuring anxiety, depression, fatigue, pain interference, and pain in the last 7 days. Previous studies lacked comparable and concurrent assessments across these 3 groups.

Results: Patients entering substance-use treatment had relatively high levels of emotional distress and poorer HRQOL relative to the general population. Among treatment modalities, patients beginning methadone treatment reported the highest levels of pain interference and pain behavior and the poorest physical functioning. Before the potentially modifying effects of methadone maintenance, patients beginning agonist therapy reported the greatest levels of compromised quality of life.

Conclusions: These data present the magnitude of differences in HRQOL characteristics between treatment and comparison groups using the same assessment rubric and may help inform the design and timing of treatment modalities, thereby enhancing treatment efficacy for patients.

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