Psychological support and new coping skills are helping patients at high risk of developing chronic pain and long-term, high-dose opioid use taper their opioids and rebuild their lives with activities that are meaningful and joyful to them.
A study of 343 post-surgical patients treated by an innovative, multidisciplinary hospital-integrated pain program at Toronto General Hospital (TGH), University Health Network (UHN) found that all patients showed reductions in pain and anxiety in the two-year study, but those who also received psychological services had greater reductions in opioid use, and their mood improved.
The study, "Acceptance and Commitment Therapy to Manage Pain and Opioid Use after Major Surgery: Preliminary Outcomes from the Toronto General Hospital Transitional Pain Service," is published in the Canadian Journal of Pain, by first author Muhammad Azam, Ph.D. candidate at York University and senior authors Dr. Joel Katz, Affiliate Scientist, Toronto General Hospital Research Institute (TGHRI) and Dr. Hance Clarke, Director of the Transitional Pain Service at TGH, UHN and Clinical Researcher, TGHRI.
Although psychological approaches to help patients cope with pain have been used previously, what is novel in this study is the combined use of a specific psychological approach with mindfulness meditation training to help patients wean off high-doses of opioids and reduce their pain-related distress and disability.
"If we lower how many opioids patients are taking, but leave them disabled and not able to live their lives, that is not helpful," says Dr. Aliza Weinrib, one of the authors of the paper and a clinical psychologist who developed this innovative psychology program and teaches it to surgical patients at TGH. "Patients can learn to respond to their pain in a different way, making it less overwhelming. They don't have to be so tied to their medications."