Skip to main content

Multidisciplinary Pain Clinics

  • Chapter
  • First Online:
Treating Comorbid Opioid Use Disorder in Chronic Pain

Abstract

Multidisciplinary Pain Clinics (MPCs) follow a model of care that emphasizes managing pain to the extent the patient’s independence is restored and overall quality of life improved, rather than complete elimination of pain. Providers from various disciplines collaborate to develop a unique treatment plan consisting of various interventions to meet the patient’s individualized needs. The intent of this chapter is to describe the literature in regard to the unique benefits and limitations of MPCs for the treatment of Comorbid Opioid Use Disorder in Chronic Pain.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Institute of Medicine. Relieving pain in America: a blueprint for transforming prevention, care, education, and research. Washington, DC: The National Academies Press; 2011.

    Google Scholar 

  2. Johannes CB, Le TK, Zhou X, Johnston JA, Dworkin RH. The prevalence of chronic pain in United States adults: results of an Internet-based survey. J Pain. 2010;11(11):1230–9.

    Article  PubMed  Google Scholar 

  3. Mosher HJ, Krebs EE, Carrel M, Kaboli PJ, Vander Weg MW, Lund BC. Trends in prevalent and incident opioid receipt: an observational study in Veterans Health Administration 2004–2012. J Gen Intern Med. 2014;1–8.

    Google Scholar 

  4. Daubresse M, Chang HY, Yu Y, Viswanathan S, Shah ND, Stafford RS, Kruszewski SP, Alexander GC. Ambulatory diagnosis and treatment of nonmalignant pain in the United States, 2000-2010. Med Care. 2013;51(10):870–8.

    Article  PubMed  Google Scholar 

  5. Mao J. Opioid-induced abnormal pain sensitivity: implications in clinical opioid therapy. Pain. 2002;100(3):213–7.

    Article  CAS  PubMed  Google Scholar 

  6. Sullivan MD, Howe CQ. Opioid therapy for chronic pain in the United States: promises and perils. Pain. 2013;154:S94–S100.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Jamison RN, Kauffman J, Katz NP. Characteristics of methadone maintenance patients with chronic pain. J Pain Symptom Manage. 2000;19(1):53–62.

    Article  CAS  PubMed  Google Scholar 

  8. Stewart WF, Ricci JA, Chee E, Morganstein D, Lipton R. Lost productive time and cost due to common pain conditions in the US workforce. JAMA. 2003;290(18):2443–54.

    Article  CAS  PubMed  Google Scholar 

  9. Pud D, Cohen D, Lawental E, Eisenberg E. Opioids and abnormal pain perception: New evidence from a study of chronic opioid addicts and healthy subjects. Drug Alcohol Depend. 2006;82(3):218–23.

    Article  CAS  PubMed  Google Scholar 

  10. Tsui JI, Herman DS, Kettavong M, Alford D, Anderson BJ, Stein MD. Physician introduction to opioids for pain among patients with opioid dependence and depressive symptoms. J Subst Abuse Treat. 2010;39(4):378–83.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Tsui JI, Cheng DM, Coleman SM, Blokhina E, Bridden C, Krupitsky E, Samet JH. Pain is associated with heroin use over time in HIV‐infected Russian drinkers. Addiction. 2013;108(10):1779–87.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Barry DT, Beitel M, Garnet B, Joshi D, Rosenblum A, Schottenfeld RS. Relations among psychopathology, substance use, and physical pain experiences in methadone-maintained patients. J Clin Psychiatry. 2009;70(9):1213.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Dhingra L, Masson C, Perlman DC, Seewald RM, Katz J, McKnight C, Homel P, Wald E, Jordan AE, Young C, Portenoy RK. Epidemiology of pain among outpatients in methadone maintenance treatment programs. Drug Alcohol Depend. 2013;128(1):161–5.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Rosenblum A, Parrino M, Schnoll SH, Fong C, Maxwell C, Cleland CM, Magura S, Haddox JD. Prescription opioid abuse among enrollees into methadone maintenance treatment. Drug Alcohol Depend. 2007;90(1):64–71.

    Article  PubMed  Google Scholar 

  15. Dunn KE, Brooner RK, Clark MR. Severity and interference of chronic pain in methadone‐maintained outpatients. Pain Med. 2014;15(9):1540–8.

    Article  PubMed  Google Scholar 

  16. Bohnert AS, Ilgen MA, Trafton JA, Kerns RD, Eisenberg A, Ganoczy D, Blow FC. Trends and regional variation in opioid overdose mortality among Veterans Health Administration patients, fiscal year 2001 to 2009. Clin J Pain. 2014;30(7):605–12.

    PubMed  Google Scholar 

  17. Trafton JA, Oliva EM, Horst DA, Minkel JD, Humphreys K. Treatment needs associated with pain in substance use disorder patients: implications for concurrent treatment. Drug Alcohol Depend. 2004;73(1):23–31.

    Article  PubMed  Google Scholar 

  18. Xiaobin C, Zunyou W, Li L, Lin P, Keming R, Changhe W, Wei L, Wenyuan Y, Jianhua L, McGoogan JM, and for the National Methadone Maintenance Treatment Program Working Group. Mortality among methadone maintenance clients in China: a six-year cohort study. PLoS One. 2013;8(12):e82476.

    Article  Google Scholar 

  19. Berg KM, Arnsten JH, Sacajiu G, Karasz A. Providers’ experiences treating chronic pain among opioid-dependent drug users. J Gen Intern Med. 2009;24(4):482–8.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Eyler EC. Chronic and acute pain and pain management for patients in methadone maintenance treatment. Am J Addict. 2013;22(1):75–83.

    Article  PubMed  Google Scholar 

  21. Chou R, Fanciullo GJ, Fine PG, Adler JA, Ballantyne JC, Davies P, Donovan MI, Fishbain DA, Foley KM, Fudin J, Gilson AM, Kelter A, Mauskop A, O’Connor PG, Passik SD, Pasternak GW, Portenoy RK, Rich BA, Roberts RG, Todd KH, Miaskowski C, and the American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel. Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009;10(2):113–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Joranson DE, Carrow GM, Ryan KM, Schaefer L, Gilson AM, Good P, Eadie J, Peine S, Dahl JL. Pain management and prescription monitoring. J Pain Symptom Manage. 2002;23(3):231–8.

    Article  PubMed  Google Scholar 

  23. Wu SM, Compton P, Bolus R, Schieffer B, Pham Q, Baria A, Van Vort W, Davis F, Shekelle P, Naliboff BD. The addiction behaviors checklist: validation of a new clinician-based measure of inappropriate opioid use in chronic pain. J Pain Symptom Manage. 2006;32(4):342–51.

    Article  PubMed  Google Scholar 

  24. Jamison RN, Edwards RR. Risk factor assessment for problematic use of opioids for chronic pain. Clin Neuropsychol. 2013;27(1):60–80.

    Article  PubMed  Google Scholar 

  25. CARF Provider search (n.d.). Retrieved on April 10, 2015 from: http://www.carf.org/advancedProviderSearch.aspx

  26. Jeffery MM, Butler M, Stark A, Kane RL. Multidisciplinary pain programs for chronic noncancer pain. Technical Brief No. 8. (Prepared by Minnesota Evidence-based Practice Center under Contract No. 290-07-10064-I.) AHRQ Publication No. 11-EHC064-EF. Rockville: Agency for Healthcare Research and Quality; 2011.

    Google Scholar 

  27. Pain Clinic Guidelines (n.d.). Retrieved March 13, 2015 from http://www.iasp-pain.org/education/content.aspx?itemnumber=1471

  28. Engel GL. The clinical application of the biopsychosocial model. J Med Philos. 1981;6(2):101–24.

    Article  CAS  PubMed  Google Scholar 

  29. Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC. The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull. 2007;133(4):581.

    Article  PubMed  Google Scholar 

  30. Malaty A, Sabharwal J, Lirette LS, Chaiban G, Eissa H, Tolba R. How to assess a new patient for a multidisciplinary chronic pain rehabilitation program: a review article. Ochsner J. 2014;14(1):96–100.

    PubMed  PubMed Central  Google Scholar 

  31. Liebschutz J, Beers D, Lange A. Managing chronic pain in patients with opioid dependence. Curr Treat Options Psychiatry. 2014;1(2):204–23.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Gatchel RJ, Okifuji A. Evidence-based scientific data documenting the treatment and cost-effectiveness of comprehensive pain programs for chronic nonmalignant pain. J Pain. 2006;7(11):779–93.

    Article  PubMed  Google Scholar 

  33. Schatman ME (2006). The demise of multidisciplinary pain management clinics? A potential strategy for addressing the conflicting ethos of business-oriented insurance and corporate healthcare versus the ends and means of right and morally sound patient care. January 1. Retrieved from http://www.practicalpainmanagement.com/resources/practice-management/demise-multidisciplinary-pain-management-clinics?page=0,4

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Travis I. Lovejoy Ph.D., M.P.H. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Diulio, A.R., Demidenko, M.I., Lovejoy, T.I. (2016). Multidisciplinary Pain Clinics. In: Matthews, A., Fellers, J. (eds) Treating Comorbid Opioid Use Disorder in Chronic Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-29863-4_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-29863-4_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-29861-0

  • Online ISBN: 978-3-319-29863-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics