Integrative Treatment for Achieving Holistic Recovery from Comorbid Chronic Pain and Opioid Use Disorder

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PROJECT SUMMARY Chronic pain and opioid use disorder (OUD) are major public health problems. Despite the alarming increases in opioid misuse and OUD, few integrated treatments target both chronic pain and OUD. Integrated holistic treatments are desperately needed that simultaneously address pain and opioid use, the fundamental causes of pain and OUD, and that focus on whole person functioning and well-being among individuals with chronic pain and opioid misuse/OUD. The University of New Mexico (UNM) Integrative Management of chronic Pain and Opioid use disorder for Whole Recovery (IMPOWR) Center will take an integrated and holistic approach to improving the lives of patients with chronic pain and opioid misuse/OUD via tailored intervention approaches to meet the needs of diverse individuals in diverse communities. We will explicitly target increasing quality of life and engagement in valued activities, the cultural centering of interventions to meet the needs of diverse patient populations, and reducing stigma of chronic pain and opioid misuse and OUD. The approaches proposed in our IMPOWR Center will directly target whole person functioning and well-being among individuals with chronic pain and misuse/OUD. Our goals are to develop, test, and implement scalable, generalizable, and sustainable provider- and patient-level interventions that are focused on improving functioning and can be delivered in diverse health care settings. To maximize impact, we have established a diverse Stakeholder Consultation Board (including people with lived experience and other stakeholders) and a Scientific Advisory Board (including experts in chronic pain, opioid misuse/OUD, and implementation science), and aim to build a sustainable workforce of researchers and providers devoted to ameliorating chronic pain and OUD via training and mentoring. All Center projects will embrace principles of community-based participatory research, team science, implementation science, economic evaluation, and open science. Consistent with our patient-centered approach, assessment of opioid use and chronic pain will be complemented with measures of psychosocial functioning and other important life domains, including stigma, engagement in valued activities, and quality of life. Projects will include economic evaluation to measure cost-effectiveness of our interventions from a societal perspective. Specific research projects will test the effectiveness, mechanisms, and implementation of an integrated psychosocial treatment for chronic pain and OUD among individuals receiving buprenorphine from outpatient OUD treatment clinics, and will use community-based participatory research methods to develop a culturally-centered implementation intervention for screening and brief intervention of chronic pain and OUD among American Indian/Alaska Native patients in primary care settings. Pilot projects focused on chronic pain and OUD will be selected by our Stakeholder Consultation Board. The UNM IMPOWR Center is committed to data harmonization, sharing of study resources, and provider training to enhance the reach, effectiveness, adoption, implementation, and maintenance of evidence-based treatments for chronic pain and OUD.