{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T07:04:29Z","timestamp":1777705469641,"version":"3.51.4"},"reference-count":45,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T00:00:00Z","timestamp":1662076800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"CareOregon, Portland OR"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Health Promot"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To explore factors related to effectiveness of nonpharmacological treatment for opioid-dependent patients suffering with chronic pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach<\/jats:title>\n                    <jats:p>A qualitative study incorporating individual interviews and focus group interviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>3 rural Oregon nonopioid pain management clinics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>A 10-week nonpharmacological educational program incorporating cognitive-behavioral therapy, movement therapy, mindfulness, and other skills.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants and methods<\/jats:title>\n                    <jats:p>Across sites, we conducted 9 individual interviews with clinic staff and 3 focus group interviews with 34 patients who had participated in the course. Thematic analysis was used to identify themes within and across respondent groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Analysis revealed 4 primary themes: program goals; program benefits; characteristics of patients who benefit from the program; coordination of clinic experiences with other care. Several primary findings can be highlighted. The clinics focused on improving patients\u2019 quality of life, while opioid use reduction was a potential secondary benefit, driven by patients. Major program benefits included enhanced pain self-management skills, patients\u2019 greater assertiveness in communications with healthcare providers, and, in numerous cases, opioid use reduction. Participants were unanimous that predisposition toward active self-management of one\u2019s pain was an essential factor for positive outcomes. Patients reported considerable variability in providers\u2019 understanding of their clinic participation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nonpharmacological approaches for treating chronic pain can be effective for many patients. Clinics teaching these approaches should be more fully integrated into the healthcare system.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08901171221119799","type":"journal-article","created":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T09:58:08Z","timestamp":1662112688000},"page":"210-221","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["\u201cThe Pain Doesn\u2019t Have to Control You.\u201d A Qualitative Evaluation of Three Pain Clinics Teaching Nonopioid Pain Management Strategies"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9525-6620","authenticated-orcid":false,"given":"Marc T","family":"Braverman","sequence":"first","affiliation":[{"name":"School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, OR, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen M","family":"Volmar","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana J","family":"Govier","sequence":"additional","affiliation":[{"name":"VA HSR&D Center to Improve Veteran Involvement in Care, Portland, OR, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,9,2]]},"reference":[{"key":"bibr1-08901171221119799","volume-title":"Opioid Overdose Crisis","author":"National Institute on Drug Abuse","year":"2022"},{"key":"bibr2-08901171221119799","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7006a4"},{"key":"bibr3-08901171221119799","volume-title":"U.S. State Opioid Dispensing Rates","author":"Centers for Disease Control and Prevention","year":"2020"},{"key":"bibr4-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.15802"},{"key":"bibr5-08901171221119799","volume-title":"Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health","author":"Substance Abuse and Mental Health Services Administration","year":"2020"},{"key":"bibr6-08901171221119799","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2018.304746"},{"key":"bibr7-08901171221119799","volume-title":"Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research","author":"Institute of Medicine","year":"2011"},{"key":"bibr8-08901171221119799","volume-title":"Engineering, and Medicine, Health and Medicine Division, Board on Health Sciences Policy, Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse","author":"National Academies of Sciences","year":"2017"},{"key":"bibr9-08901171221119799","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2022.306773"},{"key":"bibr10-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.8826"},{"key":"bibr11-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2018.10.015"},{"key":"bibr12-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1037\/a0035747"},{"key":"bibr13-08901171221119799","doi-asserted-by":"publisher","DOI":"10.7326\/M21-1436"},{"key":"bibr14-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000425"},{"key":"bibr15-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1037\/amp0000638"},{"key":"bibr16-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2010.11.017"},{"key":"bibr17-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-018-4345-6"},{"key":"bibr18-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2011.05.016"},{"key":"bibr19-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1037\/amp0000663"},{"key":"bibr20-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2018.03.009"},{"key":"bibr21-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-018-4325-x"},{"key":"bibr22-08901171221119799","volume-title":"Process for Updating the Opioid Prescribing Guideline","author":"Centers for Disease Control and Prevention","year":"2022"},{"key":"bibr23-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.38453"},{"key":"bibr24-08901171221119799","volume-title":"Oregon Prescription Drug Overdose, Misuse, and Dependency Prevention Plan","author":"Oregon Health Authority","year":"2015"},{"key":"bibr25-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2018.04.020"},{"key":"bibr26-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.0206"},{"key":"bibr27-08901171221119799","volume-title":"Columbia Pacific CCO Transformation Plan","author":"Haley M","year":"2013"},{"key":"bibr28-08901171221119799","volume-title":"CPCCO CHIP Annual Update","author":"Knopf N","year":"2016"},{"key":"bibr29-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000000388"},{"key":"bibr30-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"bibr31-08901171221119799","doi-asserted-by":"publisher","DOI":"10.4135\/9781483384436"},{"key":"bibr32-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305276687"},{"key":"bibr33-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1177\/1609406917733847"},{"key":"bibr34-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2016.07.034"},{"key":"bibr35-08901171221119799","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2015.1107782"},{"key":"bibr36-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usy018"},{"key":"bibr37-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000626"},{"key":"bibr38-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pny167"},{"key":"bibr39-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2012.01433.x"},{"key":"bibr40-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnw148"},{"key":"bibr41-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1007\/s13142-012-0158-z"},{"key":"bibr42-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2017.06.008"},{"key":"bibr43-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000488"},{"key":"bibr44-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2018.12.005"},{"key":"bibr45-08901171221119799","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2020.08.038"}],"container-title":["American Journal of Health Promotion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08901171221119799","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08901171221119799","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08901171221119799","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:03:28Z","timestamp":1777367008000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08901171221119799"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,2]]},"references-count":45,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1177\/08901171221119799"],"URL":"https:\/\/doi.org\/10.1177\/08901171221119799","relation":{},"ISSN":["0890-1171","2168-6602"],"issn-type":[{"value":"0890-1171","type":"print"},{"value":"2168-6602","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,2]]}}}