byVirginia Tech

Observed pain severity throughout the studies. Credit:Drug and Alcohol Dependence(2025). DOI: 10.1016/j.drugalcdep.2025.112902

Though rarely considered during treatment for opioid use disorder, uncontrolled pain is strongly linked to less success in treatment outcomes, a lower quality of life, and mental health issues, a new study led by a Virginia Tech addiction researcher found.

The findings,publishedrecently inDrug and Alcohol Dependence, could inform improvements in the treatment of opioid use disorder.

"We found that pain experienced during treatment and long-term recovery is a significant predictor of continuedopioid misuse," said Allison Tegge, the paper's lead and corresponding author. "Although pain commonly co-occurs with opioid disorder, and opioid pain treatment sometimes precipitates opioid use disorder, it is often not appropriately recognized and managed during opioid addiction treatment."

Tegge, research associate professor with the Fralin Biomedical Research Institute at VTC Addiction Recovery Research Center, said the study points to a need for protocols to proactively addresschronic painamong people who enter opioid treatment.

Tegge collaborated with an international team of researchers from Virginia Tech and Canada, the United Kingdom, and Australia who examined pain related to treatment and psychosocial outcomes in 602 patients, about two-thirds men, with an average age of 40. The study integrated data from three previous opioid use disorder treatment studies that investigated buprenorphine, a drug commonly used to ease patients out of addiction.

"There is almost no research on how pain changes and impacts the treatment of opioid use disorder," Tegge said. "This study fills a large gap in knowledge."

While it was common for patients to experience sustained pain reduction while in treatment, moderate tosevere painwas associated with lower rates of opioid abstinence despite increased distress. In addition, patients with greater pain severity also experienced more depression, more severe withdrawal symptoms, more opioid craving, and poorer quality of life.

Researchers said they were surprised to find that pain was not connected to patients dropping out of treatment programs.

"Taking all that together, individuals with higher pain are having less success in their treatment efforts," Tegge said.

Researchers don't know if patients are misusing opioids because they are in pain, or if the opioids themselves impact the perceptions of pain.

While more study of those questions is needed, these research findings still point to ways to improve the efficacy ofopioid use disordertreatment.

"We're always trying to change our perspective to more personalized intervention and personalized treatment, and part of that is listening to patients and recognizing the nuances of their experiences during the treatment journey," Tegge said. "At the very least, that means monitoring and addressing pain levels' alternative interventions to target pain. Reducing pain might actually improveopioidtreatment outcomes."

More information: Allison N. Tegge et al, Treatment and recovery from opioid use disorder: The role of pain severity in individuals with moderate to severe pain, Drug and Alcohol Dependence (2025). DOI: 10.1016/j.drugalcdep.2025.112902 Journal information: Drug and Alcohol Dependence

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