Evaluation of a Patient-Centred, Multidisciplinary Opioid Tapering Program for Individuals With Chronic Non-Cancer Pain on Long Term Opioid Therapy

Chronic pain management is complex, with healthcare providers historically relying on prescribing opioid medications such as morphine. Although opioids may partially improve pain, there are risks associated with them as well, including pain worsening, side effects, addiction and overdose. It is now understood that the management of chronic pain is more effective when multiple healthcare team members work together and incorporate multiple strategies instead of focusing solely on medications. An example of an effective, non-drug strategy for pain is a service offered by clinical psychologists called "Acceptance and Commitment Therapy" - or ACT - which empowers individuals, to implement alternative ways of thinking about and reacting to pain and its effect on their lives. Canada has responded to the opioid overdose crisis with new guidelines that encourage physicians and those suffering from chronic pain to aim for lower opioid doses whenever possible, a process often referred to as "tapering." Unsurprisingly, tapering opioids is often difficult for patients to consider, primarily due to misconceptions that it will cause more harm than good. This project aims to address these misconceptions by developing and offering an all-day educational workshop for patients, co-presented by a healthcare team (clinical psychologists, pharmacists and physicians), to provide in-depth information on opioid related risks and misconceptions, as well as a large component focusing on ACT training. Investigators then want to see if these sessions change individual attitudes towards opioid tapering and if it improves willingness and ability to successfully reduce opioid doses to a safer level.

Sex

All

Minimum age

18 Years

Inclusion Criteria:

* CNCP on more than half the days in the previous 6 months
* use of opioids for more than half the days in the previous 90 days
* daily morphine equivalent dose equal to or greater than 50 mg
* age 18 years or older
* cognitive ability to understand questionnaires and participate in English only education sessions
* minimum average numerical pain rating of 3/10

Exclusion Criteria:

* Currently receiving ACT or CBT
* previous experience with ACT within the past 12 months
* significant uncontrolled depression with or without suicidal ideation
* current psychosis
* known or suspected opioid misuse/abuse based on a score of seven or greater on the Opioid Risk Tool
* known or suspected opioid diversion based on previous clinician report and/or results of urine drug screen