Pain Predicts Dropout From Substance Use Treatment

Area of Science:

• Addiction Medicine
• Pain Management
• Mental Health

Background:

• Substance use disorders (SUDs) are complex conditions often co-occurring with physical pain.
• High dropout rates from residential treatment for SUDs represent a significant challenge in addiction care.
• The influence of pain on treatment adherence and outcomes in SUD populations requires further investigation.

Purpose of the Study:

• To examine the association between physical pain experienced at treatment entry and subsequent dropout from residential SUD treatment.
• To investigate whether pain intensity and endorsement predict treatment dropout.
• To explore potential exacerbation of these effects among individuals with opioid use disorder (OUD).

Main Methods:

• A cohort of 1,095 individuals undergoing residential SUD treatment was analyzed.
• Data on pain endorsement and intensity were collected within 24 hours of admission.
• Logistic regression models were used to assess the relationship between pain and treatment dropout, controlling for covariates and OUD status.

Main Results:

• Pain endorsement was significantly associated with a higher frequency of treatment dropout (OR = 1.49, p = .04).
• Increased pain intensity also predicted higher rates of dropout (OR = 1.13, p < .01).
• No significant interaction was found between opioid use disorder status and the impact of pain on dropout.

Conclusions:

• Physical pain at treatment entry is a significant predictor of early dropout in residential SUD treatment.
• Integrating pain assessment and management into SUD treatment protocols is essential for improving retention and outcomes.
• These findings highlight the critical role of addressing pain as a core component of comprehensive addiction care.