Perceived Companionship Is Associated with Pain Severity but Not Opioid Tapering Among Veterans with Chronic Pain

Chronic pain is more prevalent among Veterans than in the general population, and greater social support is linked to better pain outcomes and emotional well-being. For Veterans with chronic pain, social connections can enhance treatment effectiveness, while for those on long-term opioid therapy (LTOT), support may also facilitate pain management and opioid tapering.

To explore the relationship between self-reported companionship and changes in pain and opioid dosage among Veterans with chronic pain prescribed LTOT.

Prospective observational cohort study of primary care patients prescribed LTOT in the Veterans Health Administration PARTICIPANTS: A total of 290 Veterans prescribed LTOT MAIN MEASURES: Self-reported companionship was assessed using the 4-item PROMIS Companionship measure at 18-month follow-up, and cohorts were dichotomized into high (N=156) and low (N=134) companionship groups. We assessed pain severity and pain interference with the 3-item PEG scale along with multiple secondary measures, with up to 18 months of follow-up.

PEG scores were significantly lower in the high companionship group (6.5, 6.5, 6.3 at baseline, 12 months, and 18 months, respectively) compared to the low companionship group (7.3, 7.4, 7.1 at baseline, 12 months, and 18 months, respectively, p<0.001 in each case). High and low companionship groups did not differ significantly in mean opioid dose at any time point, nor did they differ in opioid daily dose change over time or whether dose tapering was voluntary or involuntary. High companionship was associated with significantly better general health status, less depression/anxiety, less fatigue, and better pain self-efficacy, but was not associated with sleep.

We found that high perceived companionship was associated with lower pain severity in Veterans with chronic pain on LTOT. However, changes in opioid medication dosage were not related to companionship levels. Findings suggest that approaches to enhancing companionship could be an important strategy in management of chronic pain.