Art Therapy for Chronic Pain and Opioid Use Disorder

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

40 Participants Needed

Trial Summary

What is the purpose of this trial?

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, or to state it another way, whether people with chronic pain and OUD/opioid misuse will realistically do this artistic practice on their own. A secondary question of this study is to explore whether doing this art practice can help minimize pain during the artistic process, lessen depression and anxiety, and improve feelings of social connection.

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 data supports the effectiveness of the treatment Self-Driven Repetitive Artmaking, Art Therapy, Self-Directed Art Making, Repetitive Artmaking Practice for chronic pain and opioid use disorder?

The research suggests that arts-based interventions, like music, can help reduce pain and the need for pain medication, and improve readiness for substance use disorder treatment. Although specific studies on art therapy for chronic pain and opioid use disorder are limited, the positive effects of similar arts-based strategies indicate potential benefits. ^{1 2 3 4 5}

Is art therapy safe for managing chronic pain and opioid use disorder?

The available evidence suggests that arts-based interventions, like music, are generally safe and may help reduce pain and improve motivation for treatment in people with substance use disorders. However, there is limited research specifically on art forms other than music, so more studies are needed to confirm their safety and effectiveness. ^{1 3 6 7 8}

How is the treatment Self-Driven Repetitive Artmaking different from other treatments for chronic pain and opioid use disorder?

Self-Driven Repetitive Artmaking is unique because it uses art as a therapeutic tool, allowing individuals to engage in creative expression to manage pain and reduce opioid use, unlike traditional treatments that often rely on medications or structured psychological therapies. ^{1 3 4 6 9}

Research Team

Jenny Seham, PhD

Principal Investigator

Montefiore Medical Center

Eligibility Criteria

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 am fluent in English or Spanish.

I am 18 years old or older.

Exclusion Criteria

I am not fluent in English or Spanish.

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

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

Timeline

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

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]

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]

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]

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]

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]

References

1. United States pubmed.ncbi.nlm.nih.gov

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

2. United States 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. [2021]

3. United States 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. [2023]

4. Ireland pubmed.ncbi.nlm.nih.gov

Psychophysiology of pain and opioid use: implications for managing pain in patients with an opioid use disorder. [2018]

5. Switzerland pubmed.ncbi.nlm.nih.gov

Optimizing treatment with opioids and beyond. [2019]

6. England pubmed.ncbi.nlm.nih.gov

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

7. Germany pubmed.ncbi.nlm.nih.gov

[Pain therapy in addicted patients]. [2018]

8. England 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. [2023]

9. Spain pubmed.ncbi.nlm.nih.gov

Systematic review on the clinical management of chronic pain and comorbid opioid use disorder. [2023]