An Adaptive Walking Intervention to Manage Chronic Pain in Veterans With Opioid Use Disorder Engaged in Opioid Agonist Treatment
Opioid Use Disorder, Chronic Pain
About this trial
This is an interventional treatment trial for Opioid Use Disorder focused on measuring Chronic Pain, Opioid Use Disorder, opioid agonist treatment, medications for opioid use disorder, methadone, buprenorphine, walking, exercise
Eligibility Criteria
Inclusion Criteria:
- Meet DSM5 criteria for OUD and receiving stable (i.e., unchanged in 2 weeks) dose of OAT (i.e., buprenorphine or methadone) in VACHS outpatient addiction clinic
- Report high impact chronic pain (Grade 3) that is defined by experiencing pain that interferes with work and activity on most days or every day in the past 3 months
- Self-reported ability to walk 1 block
- Access to a mobile phone with active data plan
Exclusion Criteria:
- Untreated major psychiatric disorders (e.g., bipolar disorder, psychotic disorder)
- Current (i.e., past month) active suicidal ideation
- Substance use disorder requiring inpatient detoxification
- Currently engaged in CBT for chronic pain treatment
- Planned surgical intervention for pain
Sites / Locations
- VA Connecticut Healthcare System West Haven Campus, West Haven, CTRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Steps 2 Change (S2C)
Control
Participants randomized to S2C will be scheduled for 60-minute weekly treatment sessions held over four consecutive weeks in the outpatient OAT clinic. Veterans will be expected to increase their average step counts by 10% over their prior week's average starting after Session 1. Session 1 will provide pain education including a discussion the biopsychosocial treatment model for chronic pain and benefits of activity. Session 2 and 3 will emphasize benefits of low impact physical activity and introduce activity pacing to address pain flare ups caused by cycles of over activity and subsequent sedentary behavior. Session 4 will help develop a treatment plan to continue walking and identify possible barriers to meeting goals.
Participants randomized to control will be scheduled for 60-minute weekly treatment sessions held over four consecutive weeks focused on problems associated with MOUD, substance use, and general self-management strategies. Importantly, group will explicitly avoid talking about pain coping skills and setting goals for daily step targets.