Decreasing Long-term Opioid Use in Cancer Survivors

Creating a Pathway for Disease-Free Cancer Survivors to Decrease Long-term Opioid Use

This is a feasibility pilot trial assessing a behavioral intervention for chronic pain among disease-free cancer survivors to decrease long-term opioid dependence.

To assess the feasibility and acceptability of implementing brief Acceptance and Commitment Therapy for chronic pain (ACT-CP) in a Survivorship clinic.

Inclusion Criteria:

• Diagnosis of cancer of any type, currently in remission, having completed active primary therapy. Patients on oral adjuvant hormone therapy will still be eligible.
• Completed active therapy must have been curative in intent (for example stage IV cancer patients such as head and neck cancer patients treated with curative intent are eligible).
• Self-reported cancer pain for >= 3 months
• Opioid use >= 5MME/day (morphine milligram equivalents) as prescribed by physician for cancer-related pain for at least 6 months beyond completion of their cancer treatment
• VCUHealth system patient

Exclusion Criteria:

• History of opioid use prior to cancer diagnosis
• Anyone with prior history of substance use disorder or currently enrolled in a methadone program
• Anyone with schizophrenia or bipolar disorder
• Current utilization of psychotherapy services for pain, depression, anxiety, and/or PTSD
• Cognitive concerns that would prevent meaningful engagement in treatment
• Inability to converse in English
• Lack of working telephone and Internet connection (must have at least one or the other)
• Anyone found to have progression of cancer
• Anyone diagnosed with cancer recurrence or new cancer during their study period
• Documented diagnosis of or positive screen for current substance use disorder (score >5 on the Drug Abuse Screening Test-10 [DAST-10])
• Anyone scoring >=8 on ORT indicating very high risk for opioid abuse