Counseling as chronic opioid use prevention

Hilary Mosher, MFA, MD, clinical associate professor in General Internal Medicine, and Katherine Hadlandsmyth, PhD, clinical assistant professor of Anesthesia, received a four-year, $1,400,000 Investigator Initiated Research (IIR) grant from the VA’s Health Services Research and Development Service (HSR&D). For this interdisciplinary research project, Mosher and Handlandsmyth will test a preventative program for chronic post-surgical pain and prolonged opioid use among Veterans.

Surgery can precipitate both chronic pain and long-term opioid use. Hadlandsmyth’s Perioperative Pain Self-Management (PePS) program is a four-session, telephone-based psychological intervention that teaches pain self-management skills and aims to prevent chronic postsurgical pain and prolonged opioid use.

“Dr. Hadlandsmyth and I, along with pharmacoepidemiologist Brian Lund, have collaborated on a number of projects to better understand chronic opioid therapy in chronic pain,” Mosher said. “We will study the PePS program as a promising intervention to prevent both conditions. I am delighted to continue our VA-based interdisciplinary collaboration to accelerate improvements in pain treatment.”

The PePS program is based on principles of cognitive behavioral therapy (CBT) and teaches pain self-management skills to ultimately improve long-term outcomes. Prior research has used CBT for patients with established chronic pain; however, targeting the transitional period between acute and chronic pain presents a novel preventive model. “The idea is to support patients with teaching and practicing pain self-management skills to specifically help cope with acute postoperative pain,” Hadlandsmyth said. The PePS program builds a collaborative relationship between the patient and interventionist and teaches pain coping strategies such as relaxation training, cognitive restructuring, and goal-setting.

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