Research-Based Resources to Help People with Chronic Pain and Health Care Providers Navigate Pain Management and Opioid Use

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The opioid epidemic continues to be a major health crisis in the United States. According to the Centers for Disease Control and Prevention, 93,000 people died in the United States from drug overdoses in 2020—a 30% increase from 2019—and an estimated 75% of those were opioid-related.

For people who rely on opioids and experience chronic pain and disability, treatment options are neither simple nor straightforward. Stigma and lack of information can contribute to a lack of access to care, and not all medical professionals have received training specifically on opioid use management, which can be complicated and high-risk.

AIR experts developed the Knowledge Hub through a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research, a center within the U.S. Department of Health and Human Services Administration for Community Living.

The Knowledge Hub is a centralized, easy-to-use database of evidence-informed resources designed to fill these knowledge gaps. It offers tools and information to support individuals with chronic pain and disabilities, their families, and their health care providers to better manage pain, manage opioid use in the safest manner possible, and learn how to access treatment for opioid use disorder.
 

Identifying Knowledge Gaps in Opioid Use

To ensure that the Knowledge Hub addressed the concerns and questions of people with chronic pain and providers, we conducted extensive research to determine the most common information and resource gaps. In addition to a thorough literature review of the existing resources and research articles, we also held many interviews with people with chronic pain and health care providers. Throughout the development process, we received feedback from an advisory panel, which included individuals with disabilities, primary care providers, addiction medicine specialists, and researchers.

This extensive research helped uncover numerous, significant knowledge gaps. Among the most important were:

• People who rely on opioids as part of their pain management plan are very concerned that their doctors will stop prescribing such treatments;
• There may not be many feasible pain-management alternatives to opioids for people with disabilities; and
• Distinguishing between opioid use disorder and other conditions can be challenging for physicians.
   

Resources to Fill Gaps in Opioid Use Knowledge

Below are several Knowledge Hub resources that address specific issues related to use of opioids, geared toward addressing the gaps in understanding we identified through our research.

Information to discuss pain management and opioids:

• For people with chronic pain and disabilities:
  Communicating With Your Provider to Manage Chronic Pain
  This informational planning guide is specifically designed to help people experiencing chronic pain determine and discuss options with their medical providers. Following the steps of this brief guide, people will gain a greater understanding of their pain experience and goals, know what information to share with their providers, and learn how to reach informed decisions around care.
   
• For people with chronic pain and disabilities:
  Methods for Managing Chronic Pain Other Than Medication
  There are numerous techniques that people can use to reduce chronic pain, including exercise, yoga, mindfulness and meditation, cognitive behavioral therapy, and more. This resource explains the benefits, risks, and research results for each method, as well as suggesting adaptations for persons with physical limitations.
   
• For providers:
  Communicating With People With Disability to Create a Chronic Pain Management Plan
  People with chronic pain require a holistic understanding of their experiences, including their daily activities, support systems, and emotional state. This guide helps providers gain a better understanding of their patients’ lives and goals, explain treatment options, and reach mutual decisions around a pain treatment plan.
   

Information on the difference between misuse and opioid use disorder:

• For people with chronic pain and their families:
  Understanding Signs and Symptoms of Opioid Use Disorder
  There is a difference between opioid misuse and opioid use disorder. This guide explains which behaviors are associated with opioid use disorder; crucially, it also distinguishes them from symptoms of opioid tolerance and physical opioid dependence, which are natural responses that occur when a person takes opioids as prescribed.
   
• For providers:
  Managing Difficult Conversations About Opioids
  Conversations about tapering opioids can be challenging and stressful. In this guide, providers will find strategies to prepare for these conversations, as well as questions to ask and strategies for a therapeutic approach.
   

Information about building trust and providing equal care for people with disabilities:

• For providers:
  Building Trust and Engaging People with Disability in Their Own Care
  This guide provides actionable strategies to create trustful, therapeutic relationships with people experiencing chronic pain. The suggestions are based on qualitative research with people with chronic pain as well as proven communication strategies. By treating people as partners in their own treatment, providers can improve a person’s satisfaction with their care, as well as understanding, recall, and follow-through of the treatment plan and outcomes.
   
• For people with chronic pain, families, and providers:
  Accommodations to Look for in Substance Use Treatment Programs
  This guide is designed to increase access to substance use treatment programs for people with disabilities. Program staff can use it to discover what accommodations they should implement to better serve those with disabilities. People with disabilities and their families can use it to discover what kinds of accommodations to ask about when considering a substance use treatment facility. These are just a small sampling of the resources available through the AIR Knowledge Hub.

To learn more about the Hub or access the full suite of Knowledge Hub materials, visit the Knowledge Hub home.