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Counselors' Experiences Treating Methadone-maintained Patients with Chronic Pain: A Needs Assessment Study
Declan T Barry1, Matthew J Bernard, Mark Beitel
1From the Department of Psychiatry (DTB, MB, BAM, RDK, RSS), Yale University School of Medicine, New Haven, CT; and The APT Foundation (MJB), New Haven, CT.
Purpose:
: This study was designed to conduct a needs assessment concerning methadone counselors' experiences working with methadone-maintained patients with chronic pain and measure counselors' interest in receiving specialized training to treat such patients.
Methods:
: A survey, developed by the authors, was administered to 25 counselors with a combined caseload of 956 patients at 3 opioid agonist treatment programs.
Results:
: Patients with chronic pain comprised 27% of counselors' overall caseloads. Counselors believed that, on average, 46% of these patients' pain had a psychologic component and 56% exhibited continued drug use, which patients attributed to ongoing pain. Twenty-three counselors reported an interest in receiving specialized training in treating chronic pain. A variety of management issues, including monitoring the use of pain medications and providing pain management referrals, were reported.
Conclusions:
: Findings from this needs assessment study suggest specific targets, which may be important to consider, in prospective specialized methadone maintenance treatment (MMT) counselor training and counseling for MMT patients with chronic pain.
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