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

Heath B. McAnally, MD, MSPH, Stormie M. Thompson, DO, Paul Okediji, MBChB


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.


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

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