Opioid use before and after completion of an online pain management program

Olav Nielssen, Eyal Karin, Lauren Staples, Nickolai Titov, Milena Gandy, Vincent J. Fogliati, Blake F. Dear

    Research output: Contribution to journalArticlepeer-review

    7 Citations (Scopus)


    OBJECTIVE: The purpose of this study was to examine the effect of a pain management course that has demonstrated efficacy in pain reduction on the use of opioid medication. METHOD: Self-reported medication use was recorded at baseline assessment for all patients enrolled in a validated pain management program provided free by a university research clinic (N = 471). Participants were randomized either to receive immediate treatment or to be a wait-list control. Opioid use at baseline assessment, with the daily doses converted to morphine equivalents, was compared with the self-reported opioid medication use at posttreatment and 3-month follow-up. The relationship between opioid use and measures of psychological symptoms, pain, and disability was examined. RESULTS: At assessment, 85% (n = 399) reported taking some form of pain modifying or psychotropic medication, 43.1% (n = 203) reported regular opioid use and 22.9% (n = 108) reported taking additional as required (pro re nata, or PRN) opioid-containing medication. On completion, there were significant reductions in the number who reported taking regular opioids and a large reduction in the use of PRN opioids and in the reported doses of opioids. Those reductions were more strongly associated with reductions in symptoms of anxiety and depression than in measures of disability and pain. CONCLUSIONS: The reduction in the self-reported use of regular and PRN opioid pain-relieving medication following completion of an online pain management program with demonstrated efficacy in pain reduction appeared to be related to effective treatment of symptoms of anxiety and depression.

    Original languageEnglish
    Pages (from-to)904-917
    Number of pages14
    JournalJournal of consulting and clinical psychology
    Issue number10
    Publication statusPublished - Oct 2019


    • pain
    • iCBT
    • the Pain Course
    • psychotropic medication
    • opioid


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