• Leslie W Suen, Vanessa M McMahan, Christopher Rowe, Sumeet Bhardwaj, Kelly Knight, Margot B Kushel, Glenn-Milo Santos, and Phillip Coffin.
• From National Clinician Scholars Program, Philip R. Lee Institute of Health Policy Studies, University of California San Francisco, San Francisco, CA (LWS); San Francisco Veterans Affairs Medical Center, San Francisco, CA (LWS); San Francisco Department of Public Health, San Francisco, CA (VMM, CR, GS, PC); University of Toronto, Department of Family and Community Medicine, Toronto, ON, Canada (SB); Department of Humanities and Social Sciences, University of California San Francisco, San Francisco, CA (KK); Center for Vulnerable Populations, University of California San Francisco, San Francisco, CA (MBK); Department of Community Health Systems, University of California, San Francisco, San Francisco, CA (GS); Department of Medicine, University of California, San Francisco, San Francisco, CA (PC). Leslie.Suen@ucsf.edu.
• J Am Board Fam Med. 2021 Nov 1; 34 (6): 1082-1095.

IntroductionA better understanding of pain treatment satisfaction in patients with chronic noncancer pain (CNCP) and substance use is needed, especially as opioid prescribing policies are changing. We sought to identify factors associated with pain treatment satisfaction in individuals with CNCP on recent opioid therapy and prior or active substance use.MethodsAn exploratory cross-sectional analysis using baseline data from a cohort study of 300 adults with CNCP receiving >20 morphine milligram equivalents of opioids for ≥3 of the preceding 12 months and prior or active substance use. Participants completed interviews, clinical assessments, urine drug screening, and medical chart review.ResultsParticipants were predominantly middle-aged (mean age 57.5 years), Black (44%), and cisgender men (60%). One-third (33%) had high, 28% moderate, and 39% low pain treatment satisfaction. Post-traumatic stress disorder (PTSD), tobacco use, past-year opioid discontinuation, and higher average pain scores were associated with lower satisfaction. HIV and prescription cannabis use were associated with higher satisfaction.ConclusionsThe relationship between PTSD and tobacco use with lower satisfaction should be explored to augment pain outcomes. Higher satisfaction among individuals with HIV and prescription cannabis use presents potential research areas to guide CNCP management and reduce reliance on opioid therapies.© Copyright 2021 by the American Board of Family Medicine.

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