The DOI matches its Crossref record; 28 of the 28 references it cites were found in a registry or an index.
The association of persistent pain with out-patient addiction treatment outcomes and service utilization
Open accessAbstract
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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“Perhaps more compelling, physical pain appears to be a significant predictor of alcohol use and heavy alcohol use and relapse to drinking after a period of abstinence (Larson et al., 2007;Caldeiro et al., 2008;Witkiewitz et al., 2015).”
From Drug Addiction: Hyperkatifeia/Negative Reinforcement as a Framework for Medications Development (2021) · cites this paper as Caldeiro et al., 2008
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Drug Addiction: Hyperkatifeia/Negative Reinforcement as a Framework for Medications Development
Koob, G. F. (2021) · Pharmacological Reviews · doi:10.1124/pharmrev.120.000083 · Cited by 337
Interrelations between pain and alcohol: an integrative review
Zale, E. L., Maisto, S. A., & Ditre, J. W. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.02.005 · Cited by 291
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Metadata
- 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.
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2008-11-06
- Volume
- 103
- Issue
- 12
- Pages
- 1996-2005
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- 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
- 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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