Outcomes of Psychotherapy for Co-Morbid Pain and Substance Use Disorders: A Review of the Literature.

IF 0.9 Q3 ANESTHESIOLOGY
Samuel J Mendez Araque, Lynn T Nguyen, Celeste N Nadal
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引用次数: 0

Abstract

Chronic pain is often treated with opioids, placing patients at risk for misuse. An estimated 11.5% of these patients engage in opioid misuse behaviors such as self-medication. Non-pharmacological interventions have efficacy in managing chronic pain and substance use disorders separately; comorbid management may benefit from psychotherapy. This review provides perspective on novel and existing therapies and their efficacy. The literature search was conducted using PubMed. Boolean search terms were selected from DSM and ICD diagnoses. Studies were included if patients had comorbid substance use disorder and chronic pain diagnoses, participants were age 18 or older, and psychotherapeutic interventions were implemented. The PubMed search yielded 1937 references; 25 references were obtained through other means. 30 sources met inclusion criteria. Reported trials included: Acceptance and Commitment Therapy (ACT, 2 trials); Cognitive Behavioral Therapy (CBT, 11 trials); Mindfulness-Oriented Recovery Enhancement (MORE, 5 trials); and novel psychotherapies (12 trials). Unique features included primary care (4 trials), technology such as phone or Internet (6 trials), and group settings (9 trials). Several psychotherapies effectively treat co-occurring substance use disorders and chronic pain; novel treatments continue to be developed. Further investigation may lead to a wider variety of treatments for clinical use.

疼痛与药物使用障碍并存时的心理治疗效果:文献综述
慢性疼痛通常采用阿片类药物进行治疗,这使患者面临滥用的风险。据估计,这些患者中有 11.5% 有滥用阿片类药物的行为,如自我药疗。非药物干预在单独管理慢性疼痛和药物使用障碍方面具有疗效;合并症管理可受益于心理治疗。本综述对新型疗法和现有疗法及其疗效进行了透视。文献检索通过 PubMed 进行。从 DSM 和 ICD 诊断中选择了布尔搜索条件。如果患者合并有药物使用障碍和慢性疼痛诊断,参与者年龄在 18 岁或以上,并且实施了心理治疗干预措施,则纳入研究。通过 PubMed 搜索获得了 1937 篇参考文献;通过其他途径获得了 25 篇参考文献。30篇资料符合纳入标准。报告的试验包括接受与承诺疗法(ACT,2 项试验);认知行为疗法(CBT,11 项试验);以正念为导向的康复增强疗法(MORE,5 项试验);以及新型心理疗法(12 项试验)。其独特之处包括初级护理(4 项试验)、电话或互联网等技术(6 项试验)以及小组环境(9 项试验)。有几种心理疗法能有效治疗同时存在的药物使用障碍和慢性疼痛;新型疗法仍在开发中。进一步的研究可能会开发出更多种类的治疗方法供临床使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.60
自引率
9.10%
发文量
40
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