Multimodal Inpatient Treatment for Patients with Chronic Non-Cancer Pain and Co-Morbid Substance Use Disorder (P6.275)

Objective: To evaluate a multimodal inpatient treatment program to treat patients with chronic non-cancer pain (CNCP) and substance use disorder (SUD). Background: Patients with CNCP and SUD are complex and difficult to treat. Presently, there are no protocols available to guide treatment. Novel treatment approaches that have potential for successful treatment are needed. Without such efforts, these patients will become more ill and relapse. Method: Patients were enrolled in a 45-day, inpatient chronic pain program at the Betty Ford Center. Data were collected from 2013-2015. 122 of 150 patients who consented provided complete data. Patients were evaluated on days 1-5, 30, and 45. The treating physician and staff were blinded to patients' responses. Assessments were: Beck Depression Inventory-II, Brief Pain Inventory, McGill pain questionnaire, and patient portion of the West Haven-Yale Multidimensional Pain Inventory. Treatment consisted of 15 hours/week of group process and education, external and internal qigong, osteopathic manual medicine, and qigong-based mindfulness. Patients also received 20 hours per week of recovery- based SUD treatment. A mixed model analysis was used to evaluate treatment progress (above listed measures). Each mixed model included time as categorical (the three time points), age and gender as fixed effects, and patient as a random effect (random-intercept model). If the time main effect was significant (p < .05), Tukey-Kramer post-hoc tests were used for multiple comparisons. Results were plotted using adjusted means with 95[percnt] confidence intervals. All analyses were conducted using SAS version 9.4. Results: Results were consistently similar across all measures (total and subscale scores). Patients showed marked improvement in depression and pain ratings, and these improvements were robust and statistically significant. Conclusion: The findings are sufficiently encouraging to warrant further evaluation of the protocol and to plan both comparative studies and studies beyond patients' 45 day inpatient stay.