How to wean friends and influence health: Opioid weaning and discontinuation aided by a simple health and wellness coaching program

Authors

DOI:

https://doi.org/10.5055/jom.2023.0759

Keywords:

chronic opioid use, opioid weaning, opioid discontinuation, health and wellness coaching, pain neuroscience education, multidisciplinary, therapeutic alliance

Abstract

Objective: To evaluate whether a simple health and wellness coaching (HWC) program embedded within routine clinical practice resulted in improved opioid weaning and discontinuation.

Design: Retrospective double cohort study comparing longitudinal opioid use data and numeric pain scale ratings for patients in each group.

Setting: Single noninstitutional subspecialty pain management practice.

Participants: Twenty (daily opioid using) patients undergoing a multifocal HWC program with integrated pain neuroscience education (PNE) compared to 20 age- and gender-matched (daily opioid using) patients undergoing usual care.

Intervention: A systematized series of interactive self-management topics/lessons on basic health topics pertinent to chronic pain, eg, posture, mobility, nutrition, sleep, stress management, and PNE.

Main outcome measures: Daily morphine milligram equivalents (MMEs) trajectory and discontinuation success (hypothesis and outcome measure formulated before data collection); numeric pain scale rating trajectory (hypothesis and outcome measure formulated after data collection).

Results: MME decrease was significantly greater among cases (93.5 percent) than controls (50 percent; p = 0.004) as was discontinuation of opioids (30 percent vs 0). Cases reported decreased longitudinal 10-digit pain scale rating (–0.8) compared to controls (+0.1) without statistical significance.

Conclusions: Providing simple and salient HWC including PNE within pain management can significantly improve opioid weaning and discontinuation while mitigating pain.

Author Biographies

Heath B. McAnally, MD, MSPH

Northern Anesthesia and Pain Medicine, Eagle River, Alaska; Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington

Stormie M. Thompson, DO

Department of Anesthesiology, Virginia Mason Medical Center, Seattle, Washington

Paul Okediji, MBChB

MedInsight Research Institute, Rehovot, Israel

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Published

01/01/2023

How to Cite

McAnally, MD, MSPH, H. B., S. M. Thompson, DO, and P. Okediji, MBChB. “How to Wean Friends and Influence Health: Opioid Weaning and Discontinuation Aided by a Simple Health and Wellness Coaching Program”. Journal of Opioid Management, vol. 19, no. 1, Jan. 2023, pp. 57-67, doi:10.5055/jom.2023.0759.