SBIRT for Pain Management in Substance Use Disorders
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial tests a new approach called SBIRT-PM (Screening, Brief Intervention, and Referral to Treatment for Pain Management) to help veterans manage chronic pain and reduce risky substance use. The treatment involves phone counseling to encourage veterans to explore various non-drug pain management options and decrease reliance on substances. Veterans who have applied for compensation for musculoskeletal (MSD) issues and experience moderate to severe pain might be a good fit. As an unphased trial, this study provides veterans with a unique opportunity to explore innovative pain management strategies tailored to their needs.
Do I need to stop my current medications for this trial?
The trial information does not specify whether you need to stop taking your current medications. It might be best to discuss this with the trial coordinators or your doctor.
What prior data suggests that SBIRT-PM is safe for pain management in substance use disorders?
Research shows that SBIRT-PM helps Veterans manage pain and reduce risky substance use. Early studies have found that this method can improve pain management without drugs. SBIRT-PM involves counseling to help Veterans find non-drug ways to manage pain, making it a low-risk option.
The treatment includes discussions with a clinician about non-drug methods for handling pain. This approach is generally safe and well-tolerated because it doesn't involve new medications. Reports of significant side effects are absent since it mainly involves discussions and planning for better pain care.
In summary, SBIRT-PM is a safe choice for managing pain while reducing substance use. It uses counseling to support Veterans, so there are few risks involved.12345Why are researchers excited about this trial?
Researchers are excited about SBIRT-PM because it offers a fresh approach to managing chronic pain in veterans with substance use disorders. Unlike standard treatments that often rely heavily on medications, SBIRT-PM emphasizes non-pharmacological pain management strategies, encouraging veterans to explore a range of therapies beyond just pills. This approach not only addresses the pain directly but also helps manage substance misuse by motivating veterans to consider healthier pain management options. This dual focus on pain and substance use makes SBIRT-PM a promising method that could lead to better overall outcomes for veterans struggling with these intertwined issues.
What evidence suggests that SBIRT-PM is effective for pain management in substance use disorders?
Research has shown that SBIRT-PM, the experimental treatment in this trial, can help veterans manage pain and reduce substance misuse. SBIRT-PM guides veterans to use various methods for pain treatment while addressing their substance use. Studies indicate that veterans participating in SBIRT-PM are more likely to adopt comprehensive pain management strategies. SBIRT-PM also helps veterans understand how substances impact their pain and encourages healthier behavior changes. This approach has shown promise in improving pain management and reducing risky substance use.12346
Who Is on the Research Team?
Marc Rosen, MD
Principal Investigator
Yale University/ VA Connecticut Healthcare System
Steve Martino, PhD
Principal Investigator
Yale University/ VA Connecticut Healthcare System
Are You a Good Fit for This Trial?
This trial is for post-9/11 veterans who are applying for compensation due to musculoskeletal conditions, have moderate to severe pain (scoring ≥4 on a pain scale), and own a phone. It's not open to those unable or unwilling to participate, those already receiving multiple non-drug pain treatments from the VA, or participants in another related study.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants receive SBIRT-PM counseling to address pain management and substance use
Follow-up
Participants are monitored for safety and effectiveness after treatment
What Are the Treatments Tested in This Trial?
Interventions
- SBIRT-PM
Trial Overview
The SBIRT-PM program is being tested for its effectiveness in reducing chronic pain and risky substance use among veterans. The program involves clinicians contacting veterans by phone across New England as part of a pragmatic randomized clinical trial.
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
Active Control
Screening, Brief Intervention and Referral to Treatment for Pain Management (SBIRT-PM) was developed to promote engagement in multi-modal non-pharmacological pain management among compensation-seeking Veterans with chronic pain. In SBIRT-PM, a clinician meets with the Veteran after the compensation examination to address the presenting MSD complaint. The clinician addresses Veterans' motivation for multi-modal pain care, and explains how pain can be managed using a variety of non-pharmacological pain management services. The clinician spells out how those services can be accessed at VA. Using permissive language about how pain is commonly self-medicated with substances, the clinician transitions to inquiries about use of prescription and non-prescription substances. The clinician then attempts to motivate Veterans to change their behavior if they are misusing substances. Thus, SBIRT-PM addresses the Veteran's presenting pain complaint first and nascent substance use subsequently.
A Veteran who completes a Compensation examination ordinarily has no further treatment, referral or debriefing as part of the Compensation examination. Veterans will be advised that they should continue to pursue whatever counseling they need outside the study.
Find a Clinic Near You
Who Is Running the Clinical Trial?
Yale University
Lead Sponsor
National Center for Complementary and Integrative Health (NCCIH)
Collaborator
US Department of Veterans Affairs
Collaborator
National Institute on Drug Abuse (NIDA)
Collaborator
Citations
Screening, Brief Intervention, and Referral to Treatment for ...
SBIRT-PM could help Veterans, at the time of their compensation claims, use multimodal pain treatments and reduce existing substance misuse.
SBIRT-PM Study Protocol - PubMed
A multisite randomized clinical trial is testing the effectiveness and cost-effectiveness of Screening, Brief Intervention, and Referral to Treatment for Pain ...
Screening, brief intervention, and referral to treatment for pain ...
The proportion of participants who receive any SBIRT-PM will be the primary implementation outcome. Veteran participants will complete baseline, ...
Study Details | NCT04062214 | Pragmatic RCT of SBIRT-PM
The Investigators propose to test the effectiveness and cost-effectiveness of Screening, Brief Intervention and Referral to Treatment for Pain Management ( ...
5.
journals.lww.com
journals.lww.com/c-orthopaedicpractice/fulltext/2022/03000/screening,_brief_intervention,_and_referral_to.3.aspxScreening, brief intervention, and referral to treatment...
Patients who screened as medium or high risk were 5.8 and 8.4 times more likely, respectively, to receive intervention compared with patients who screened to ...
Screening, Brief Intervention, and Referral to Treatment ...
The percentage of clients who reported they had not used alcohol or illegal drugs within the past 30 days increased by 128.8% between initial ...
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