Cited by 122Substance Abuse Treatment and OutcomesOpioid Use Disorder TreatmentHomelessness and Social Issues

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The association of persistent pain with out-patient addiction treatment outcomes and service utilization

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Caldeiro, Ryan M., Malte, Carol A., Calsyn, Donald A., Baer, John S., Nichol, Paul, Kivlahan, Daniel R., Saxon, Andrew J.·2008·Addiction

DOI 10.1111/j.1360-0443.2008.02358.x

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Aims To estimate the prevalence of persistent pain among veterans in out‐patient addiction treatment and examine associated addiction treatment outcomes and medical and psychiatric service use. Design, setting and participants Analysis of data from a prospective randomized controlled trial comparing on‐site versus referral primary care of veterans with substance dependence ( n = 582), excluding opioid dependence who had at least one follow‐up interview during the 12‐month study period in a Veterans Affairs (VA) out‐patient addiction treatment center. Measurements Pain status was classified as persistent (pain was rated moderate to very severe at all time‐points), low (pain was rated none to mild at all time‐points) or intermittent (all others). Main outcome measures were addiction treatment retention, addiction severity index (ASI) alcohol and drug composite scores, VA service utilization and treatment costs. Findings A total of 33.2% of veterans reported persistent pain and 47.3% reported intermittent pain. All groups benefited from addiction treatment, but veterans with persistent pain were in treatment for an estimated 35.1 fewer days [95% confidence interval (CI) = −64.1, −6.1, P = 0.018], less likely to be abstinent from alcohol or drugs at 12 months [odds ratio (OR) adj = 0.52; 95% CI = 0.30,0.89; P = 0.018], had worse ASI alcohol composite scores at 12 months (β adj = 0.09; 95% CI = 0.02,0.15; P = 0.007), were more likely to be medically hospitalized (OR adj = 2.70; 95% CI = 1.02,7.13; P = 0.046) and had higher total service costs compared to those with low pain ($17 766 versus $13 261, P = 0.012). Conclusions Persistent pain is common among veterans in out‐patient addiction treatment and is associated with poorer rates of abstinence, worse alcohol use severity and greater service utilization and costs than those with low pain.

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Authors: Caldeiro, R. M., Malte, C. A., Calsyn, D. A., Baer, J. S., Nichol, P., Kivlahan, D. R., & Saxon, A. J.
Affiliations: University of Washington (US)
VA Puget Sound Health Care System (US)
Corresponding author: Caldeiro, Ryan M.
ORCID: Caldeiro, Ryan M.
Malte, Carol A.
Baer, John S.
Saxon, Andrew J.
Venue: Addiction
Publisher: Wiley
Published: 2008-11-06
Volume: 103
Issue: 12
Pages: 1996-2005
ISSN: 0965-2140 (ISSN-L)
1360-0443
DOI: 10.1111/j.1360-0443.2008.02358.x
OpenAlex: W2032644022
Cited by: 122
References: 28
Citations by year: 2026: 6 · 2025: 9 · 2024: 11 · 2023: 4 · 2022: 5 · 2021: 6 · 2020: 9 · 2019: 8 · 2018: 10 · 2017: 8 · 2016: 10 · 2015: 11 · 2014: 7 · 2013: 4 · 2012: 4
FWCI: 2.45
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Addiction (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Veterans Affairs
Health Services Research and Development
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Social Sciences › Sociology and Political Science › Homelessness and Social Issues
Keywords: chronic pain, veterans, outpatient addiction treatment, substance dependence, treatment retention, abstinence, alcohol use severity, health care utilization, hospitalization, treatment costs, primary care referral
MeSH terms: Adult, Female, Humans, Male, Middle Aged, Outpatient Clinics, Hospital, Pain, Pain Measurement, Patient Compliance, Prospective Studies, Veterans, Prevalence, Substance Abuse Treatment Centers, Treatment Outcome, Substance-Related Disorders

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The association of persistent pain with out-patient addiction treatment outcomes and service utilization

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