Art Therapy for Chronic Pain and Opioid Use Disorder

No longer recruiting at 1 trial location

Overseen By Jenny Seham, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Montefiore Medical Center

Must be taking: OUD medications

Disqualifiers: Non-English/Spanish speakers, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines whether individuals with chronic pain and opioid use disorder (OUD) or opioid misuse find self-directed art making (also known as Self-Driven Repetitive Artmaking) helpful and whether they will engage in it independently. The study aims to determine if this art practice can reduce pain, alleviate depression and anxiety, and enhance social connections. Participants should have chronic pain and have recently used medication for OUD or meet criteria for opioid misuse. As an unphased study, this trial provides a unique opportunity to explore a creative approach to managing chronic pain and improving mental health.

Will I have to stop taking my current medications?

The trial protocol does not specify whether you need to stop taking your current medications. It seems likely that you can continue your current treatment, especially since the study focuses on art therapy rather than medication changes.

What prior data suggests that self-driven repetitive artmaking is safe for people with chronic pain and opioid use disorder?

Research has shown that art therapy is generally safe for individuals with chronic pain and those dealing with opioid use disorder. A review of 16 studies found that most patients experienced positive effects, such as improved pain management, without major negative side effects.

Other research found that participants in art projects often experienced unexpected benefits, such as improved emotional well-being. These studies reported no serious safety issues, suggesting that creating art independently is likely safe and well-tolerated for most people. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using self-driven repetitive artmaking for chronic pain and opioid use disorder because it offers a non-drug approach to managing pain and addiction. Unlike standard treatments that often rely on medications like opioids and antidepressants, this method empowers patients to engage in creative activities, which may help reduce pain perception and the need for opioids. Additionally, art therapy provides a unique emotional outlet and can improve mental well-being, offering a holistic complement to traditional therapies.

What evidence suggests that self-driven repetitive artmaking might be an effective treatment for chronic pain and opioid use disorder?

Research shows that art therapy can help manage chronic pain. A review of 16 studies found that art therapy positively affected pain management. Patients reported less pain and an overall improvement in well-being. Other studies noted that art therapy also improved mental health by reducing depression and anxiety. In this trial, participants will engage in self-driven repetitive art-making. Although limited direct evidence exists on independently done art-making, these findings suggest it might offer similar benefits. ^{1 2 4 6 7}

Who Is on the Research Team?

Jenny Seham, PhD

Principal Investigator

Montefiore Medical Center

Are You a Good Fit for This Trial?

This trial is for individuals with chronic pain and opioid use disorder or opioid misuse. It's designed to see if they will engage in self-driven artmaking on their own as a potential therapeutic activity.

Inclusion Criteria

Have received medication for OUD in the past 30 days or meet criteria for opioid misuse

I experience chronic pain.

Exclusion Criteria

Do not otherwise meet the inclusion criteria for age, OUD, Opioid misuse, and chronic pain.

I cannot attend the workshop due to language or other non-physical barriers.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

In-Person Workshop

Participants attend a two-hour in-person workshop led by an Art Therapist to gather patient characteristic data and orient them to the use of art kits.

2 hours

1 visit (in-person)

At-Home Artmaking

Participants use art kits at home up to four times over four months, completing pre- and post-surveys to assess pain, mood, and social connectivity.

4 months

Follow-up

Participants are monitored for safety and effectiveness after the artmaking intervention, including qualitative feedback sessions.

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Self-Driven Repetitive Artmaking

Trial Overview The study tests the acceptability of self-directed repetitive artmaking practice. It aims to determine if this creative process can reduce pain, alleviate depression and anxiety, and enhance social connectedness among participants.

How Is the Trial Designed?

Group I: Art Making Experimental Treatment 1 Intervention

Each patient will receive artmaking kits

Who Is Running the Clinical Trial?

Montefiore Medical Center

Lead Sponsor

Trials

468

Recruited

599,000+

National Institute on Drug Abuse (NIDA)

Collaborator

Trials

2,658

Recruited

3,409,000+

Published Research Related to This Trial

A multisite randomized controlled trial involving 160 veterans with chronic pain and opioid use disorder will evaluate the efficacy of an integrated treatment combining Acceptance and Commitment Therapy and Mindfulness-Based Relapse Prevention, focusing on pain interference and hazardous opioid use.

The study aims to address a significant gap in treatment options by assessing outcomes over 12 months, including pain interference and opioid misuse, which could lead to improved care for veterans on buprenorphine.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Rationale and design of a multisite randomized clinical trial examining an integrated behavioral treatment for veterans with co-occurring chronic pain and opioid use disorder: The pain and opioids integrated treatment in veterans (POSITIVE) trial. Vowles, KE., Witkiewitz, K., Clarke, E., et al.[2023]

A systematic review of 593 articles identified nine studies focusing on treatments for patients with chronic pain and opioid use disorder, highlighting that methadone and buprenorphine, along with cognitive-behavioral and mindfulness therapies, showed promising but inconclusive results.

The review suggests that there is uncertainty regarding the best approach for opioid agonist treatment and emphasizes the need for individualized therapeutic strategies based on shared decision-making, as psychological therapies improved emotional well-being but not pain management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Systematic review on the clinical management of chronic pain and comorbid opioid use disorder. Jiménez-Fernández, B., Calomarde-Gómez, C., López-Lazcano, A., et al.[2023]

Arts-based interventions, particularly music, have shown promise in reducing pain and the need for pain medication, as well as improving treatment readiness and motivation for individuals with substance use disorders (SUD).

The review highlights a critical gap in research on art forms other than music, suggesting that future studies should explore the long-term benefits of various arts-based interventions for pain management and SUD prevention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An Integrative Review of Arts-Based Strategies for Addressing Pain and Substance Use Disorder During the Opioid Crisis. Leis, JA., Morrison, CI.[2021]

Individuals with a history of opioid misuse experience higher levels of hyperalgesia, which may be linked to changes in psychophysiological pathways, complicating their pain management.

There is a need for more research into the psychophysiological biomarkers of patients with both chronic pain and opioid use disorder to improve treatment strategies and outcomes for this challenging group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Psychophysiology of pain and opioid use: implications for managing pain in patients with an opioid use disorder. Wachholtz, A., Foster, S., Cheatle, M.[2018]

Chronic pain is reported by 33.4% of individuals entering opioid use disorder (OUD) treatment programs, but 66% of those with chronic pain do not have their pain managed within these programs, leading to worsening pain for 47% of them.

The lack of effective pain management in OUD treatment is linked to a higher risk of opioid relapse, highlighting the need for interdisciplinary care and evidence-based policies to improve pain management and treatment outcomes for OUD patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessment of Chronic Pain Management in the Treatment of Opioid Use Disorder: Gaps in Care and Implications for Treatment Outcomes. Ellis, MS., Kasper, Z., Cicero, T.[2021]

Patients with chronic pain and substance use disorders face unique challenges that traditional treatment programs often fail to address, leading to inadequate care and poor outcomes.

A new integrated treatment approach is needed, focusing on a comprehensive evaluation of each patient's specific issues, which can help design effective therapies that address both chronic pain and addiction simultaneously.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Optimizing treatment with opioids and beyond. Clark, MR., Treisman, GJ.[2019]

Patients with a history of drug addiction can still receive effective pain management without the risk of addiction, provided that the therapy is tailored to their specific physiological and psychological needs.

Successful pain therapy for drug-dependent individuals requires a multimodal approach that considers their unique challenges and includes interdisciplinary collaboration to optimize treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Pain therapy in addicted patients]. Hampel, C., Schenk, M., Göbel, H., et al.[2018]

A novel opioid preference task was validated among 87 veterans on long-term opioid therapy for chronic pain, showing that preference for opioid-related images correlates with the severity of opioid use disorder (OUD) symptoms.

The study found a significant positive correlation between the choice for opioid-related images and OUD severity, particularly in those diagnosed with OUD, suggesting this task could effectively track OUD symptoms without the ethical concerns of direct drug administration.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Simulated opioid choice linked to opioid use disorder severity among veterans with chronic pain: initial validation of a novel paradigm. Parikh, A., Moeller, SJ., Garland, EL.[2023]

In a retrospective overview of 42 patients with Opioid Use Disorders, 62% showed significant positive responses to unilateral transcranial photobiomodulation (UtPBM) as an adjunct therapy, indicating its potential efficacy in enhancing treatment outcomes.

The treatment was reported to be safe, with no significant side effects observed, aside from temporary anxiety in two patients that resolved with psychotherapy, suggesting that UtPBM could be a beneficial addition to existing therapies for OUD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Unilateral transcranial photobiomodulation for opioid addiction in a clinical practice: A clinical overview and case series. Schiffer, F.[2021]

Citations

1. centerwatch.com centerwatch.com/clinical-trials/listings/NCT06554431/assessing-the-efficacy-of-self-driven-repetitive-artmaking-practice?activelyRecruiting=false&page=586&id=45&slug=chronic-pain

Assessing the Efficacy of Self-Driven Repetitive Artmaking Practice The primary purpose of this study is to assess the acceptability of self-directed art making for people with chronic pain and OUD/opioid misuse, ...

2. withpower.com withpower.com/trial/art-therapy-for-chronic-pain-and-opioid-use-disorder-a443c

Art Therapy for Chronic Pain and Opioid Use Disorder The primary purpose of this study is to assess the acceptability of self-directed art making for people with chronic pain and OUD/opioid misuse, ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10616022/

Arts Therapy and Its Implications in Chronic Pain Management We reviewed 16 studies of different design, and the majority reported beneficial effects of art therapy in patients' management of chronic pain.

4. digitalcommons.lesley.edu digitalcommons.lesley.edu/cgi/viewcontent.cgi?article=1439&context=expressive_theses

The Effectiveness of Art Therapy as a Treatment Modality in ... this treatment modality is to improve overall life functioning and mental health, with the potential of reducing physical pain sensations as ...

5. tandfonline.com tandfonline.com/doi/full/10.1080/24740527.2024.2352876

Full article: The use of Arts-Based Research in Chronic Pain Nine articles reported that their arts-based research methods produced unintended therapeutic benefits for participants. Recommendations for future research ...

6. scholarworks.indianapolis.iu.edu scholarworks.indianapolis.iu.edu/server/api/core/bitstreams/28817ce1-d956-4492-a467-2cd5679ca744/content

ART THERAPY IN OPIATE USE DISORDER Submitted to the faculty of the Art Therapy Program in partial fulfillment of the requirements for the degree. Master of Arts in Art Therapy.

7. researchgate.net researchgate.net/publication/374103588_Arts_Therapy_and_Its_Implications_in_Chronic_Pain_Management_A_Narrative_Review

(PDF) Arts Therapy and Its Implications in Chronic Pain ... We reviewed 16 studies of different design, and the majority reported beneficial effects of art therapy in patients' management of chronic pain and improvement ...