Research Publications

@article{pmid39117511,

title = {Perspectives on Online Resources for People Experiencing Pain: A Qualitative Study},

author = {Marian Wilson and Janet R Katz and Mafe D Chase and Ross J Bindler and Teresa L Rangel and Rebecca A Penders and Pamela S Kohlmeier and Jamie Lewis},

doi = {10.1016/j.pmn.2024.07.006},

issn = {1532-8635},

year  = {2025},

date = {2025-02-01},

journal = {Pain Manag Nurs},

volume = {26},

number = {1},

pages = {14--22},

abstract = {BACKGROUND: Innovations in technology offer potential solutions to address pain care inequities. To maximize impacts, greater understanding is needed regarding preferences and priorities of people experiencing or treating pain.nnOBJECTIVES: This study conducted focus groups to investigate the perspectives of people with pain and healthcare workers regarding online resources for pain management. Researchers asked about barriers to current pain management and what resources would be most desired in an online format to meet needs.nnMETHODS: Participants were a randomly selected sub-sample of adults from a northwestern region of the United States who participated in an online, survey-based study. Eligible participants identified as either a person who had received treatment for pain or a healthcare worker who cared for people with pain. Of the 199 survey respondents, 30 participated in one of three focus group sessions. Focus groups were conducted using videoconferencing technology, then recorded, transcribed, and analyzed using thematic analysis.nnRESULTS: Focus group participants included 22 adults who identified as a person treated for pain of any type and 8 healthcare workers. Themes relating to eHealth use reflected desires for (1) freely accessible and vetted pain management information in one place, (2) reliable information tailored to need and pain type, and (3) easy-to-use resources. Findings revealed that some effective pain management resources do exist, yet obstacles including inflexible and inequitable healthcare practices and lack of knowledge about options may limit access to these resources.nnCONCLUSION: Including preferences of user groups can assist in creating resources that are likely to be useful for those with pain and their caregivers. Innovations are needed to address persisting gaps in care.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39603859,

title = {Disparities, Inequities, and Injustices in Populations With Pain: Nursing Recommendations Supporting ASPMN's 2024 Position Statement},

author = {Marian Wilson and Staja Booker and Anitha Saravanan and Navdeep Singh and Brian Pervis and Gloria Mahalage and Mitchell R Knisely},

doi = {10.1016/j.pmn.2024.10.016},

issn = {1532-8635},

year  = {2024},

date = {2024-11-01},

journal = {Pain Manag Nurs},

abstract = {The American Society for Pain Management Nursing (ASPMN) upholds the principle that all persons with pain have equal rights to evidence-based, high quality pain assessment, management, and treatment. This practice recommendation's goals are to 1) summarize known pain-related disparities, inequities, and injustices among commonly marginalized and at risk groups, 2) offer recommendations to ascertain that just and equitable pain care is provided to all people, and 3) outline a call to action for all nurses to embrace diversity, equity, inclusion, and a sense of belonging in order to mitigate pain-related disparities, inequities, and injustices within clinical environments and the nursing profession. This paper provides background and rationale for the 2024 ASPMN position statement on disparities, inequities and injustices in people with pain.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39537496,

title = {Disparities, Inequities, and Injustices in Populations With Pain: An ASPMN Position Statement},

author = {Mitchell R Knisely and Staja Q Booker and Anitha Saravanan and Navdeep Singh and Brian Pervis and Gloria Mahalage and Marian Wilson},

doi = {10.1016/j.pmn.2024.10.015},

issn = {1532-8635},

year  = {2024},

date = {2024-11-01},

journal = {Pain Manag Nurs},

abstract = {Disparities, inequities, and injustices in populations with pain are historically pervasive and lead to deleterious patient outcomes and perpetuate systemic barriers to achieving equitable pain management. The American Society for Pain Management Nursing (ASPMN) upholds the principle that all persons with pain have equal rights to evidence-based, high quality pain assessment, management, and treatment. Intervening at multilevels (i.e., individual, interpersonal, community, societal) is necessary to ascertain that just and equitable pain care is provided to all populations.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37455185,

title = {Interprofessional Education to Address Substance Use among Adults with Persistent Pain: A Pre-Post Program Evaluation},

author = {Marian Wilson and Skye McKennon and Connie M Remsberg and Ross J Bindler and Jennifer Anderson and Tracy A Klein and Rie Kobayashi and Jennifer C Miller and Dawn E DeWitt},

doi = {10.1016/j.pmn.2023.06.005},

issn = {1532-8635},

year  = {2023},

date = {2023-10-01},

journal = {Pain Manag Nurs},

volume = {24},

number = {5},

pages = {558--566},

abstract = {BACKGROUND: Substance use disorders (SUDs) are highly prevalent among adults with persistent pain. Yet, standard competencies for integrating pain and SUD content are lacking across health science student curricula. Additionally, pharmacotherapies to treat SUDs are underutilized.nnAIM: To address these gaps, a team of health science faculty created an interprofessional simulation activity using a standardized patient and evaluated learner outcomes related to assessment and treatment of comorbid persistent pain and substance use.nnMETHODS: A total of 304 health science students representing nursing, medicine, pharmacy, and social work programs attended virtual learning sessions. Interprofessional student teams developed a team-based care plan for an adult with musculoskeletal pain who takes prescribed opioids while using alcohol. Pre- and post-activity surveys assessing knowledge and confidence were matched for 198 students. Descriptive statistics summarized survey data with inferential analysis of paired data.nnRESULTS: The largest significant improvements between pre- and post-activity knowledge were observed in items specific to pharmacotherapy options for alcohol and opioid use disorders. Similar gains were noted in students' confidence regarding pharmacotherapies. No significant differences were noted on pre-post-activity knowledge scores between the three main profession groups (medicine, nursing, and pharmacy).nnCONCLUSIONS: Students attending this interprofessional simulation demonstrated improved knowledge and confidence, particularly in pharmacotherapies for alcohol and opioid use disorders. Replication of such programs can be used to provide consistent content across health science disciplines to heighten awareness and receptivity to medications available to treat SUDs in people treated for persistent pain. The curriculum is freely available from the corresponding author.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Remsberg2023,

title = {An Interactive Online Interprofessional Opioid Education Training Using Standardized Patients},

author = {Connie M. Remsberg and Barbara Richardson and Brenda S. Bray and Marian Wilson and Rie Kobayashi and Tracy Klein and Jennifer Anderson and Sarah Peterson and Carrie Gigray and Dawn DeWitt},

doi = {10.15766/mep_2374-8265.11328},

issn = {2374-8265},

year  = {2023},

date = {2023-08-08},

journal = {MedEdPORTAL},

publisher = {Association of American Medical Colleges},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37179236,

title = {Experiencing COMFORT: Perceptions of Virtually-delivered Nonpharmacologic Therapies in Adults Prescribed Opioids for Chronic Pain},

author = {Emily Gray and Morgan Erickson and Ross Bindler and Deborah U Eti and Marian Wilson},

doi = {10.1016/j.pmn.2023.04.002},

issn = {1532-8635},

year  = {2023},

date = {2023-08-01},

journal = {Pain Manag Nurs},

volume = {24},

number = {4},

pages = {469--476},

abstract = {BACKGROUND: An opioid task force within an urban public health district sought to increase access to, and utilization of, non-opioid, nonpharmacologic alternatives for pain management.nnAIMS: The COMFORT (Community-engaged Options to Maximize and Facilitate Opioid ReducTion) study was designed to provide virtual multidimensional integrated nonpharmacologic therapies via a cloud-based videoconferencing platform over six weeks to adults with chronic pain who were prescribed an opioid to investigate measurable health improvements.nnMETHODS: A qualitative descriptive analysis explored participants' experiences of a novel pain management intervention. A total of 19 participants consented to participate in the study and 15 completed six virtual consultations with either yoga, massage, chiropractic, or physical therapists. Semi-structured exit interviews were conducted, and data analyzed using content analysis.nnRESULTS: Five main themes were identified, including unmet pain needs, self-care practices, incentive for participation, perception of a virtual environment, and benefits of the intervention. All participants reported at least minor benefits, with about half reporting improvement in pain levels, and some were able to reduce their opioid use. A virtual environment posed challenges for a few participants who found it more difficult to engage with than in-person therapy; others found the platform easy to navigate.nnCONCLUSIONS: Participants with chronic pain were open and willing to try a novel way to access nonpharmacologic consultations to address unmet pain needs. Virtual consultations with pain management experts may increase access to, and utilization of, complementary and integrative treatment modalities.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Finlay2023,

title = {0865 Feasibility of a Disposable Home Sleep Test Device in a Chronic Pain Population Prescribed Opioids},

author = {Myles Finlay and Ross Bindler and Marian Wilson},

doi = {10.1093/sleep/zsad077.0865},

issn = {1550-9109},

year  = {2023},

date = {2023-05-29},

volume = {46},

number = {Supplement_1},

pages = {A381--A381},

publisher = {Oxford University Press (OUP)},

abstract = {Abstract

               

                  Introduction

                  Opioids are a common pain treatment in the United States with approximately 143 million prescriptions dispensed in 2020. Long-term opioids for chronic pain increase risk of misuse and overdose. Opioids can also disrupt sleep and cause respiratory depression while poor sleep can exacerbate pain. In-lab polysomnography is the standard for diagnosing sleep disorders. However, polysomnography is less effective for observing patterns over multiple days and is not always representative of at-home sleep. This study investigates the feasibility of using a disposable home sleep test device with adults prescribed opioids for chronic pain and its ability to screen for sleep disorders and overnight oxygenation.

               

               

                  Methods

                  Participants were recruited from clinics and public advertisements. Key inclusion criteria were: ≥18 years of age, moderate daily level of pain (≥5 on the 0-10 Numeric Pain Scale [NPS]), prescribed opioids, and internet access. The NightOwl mini disposable home sleep test (Ectosence, Leuven, Belgium) was used to record total sleep time (TST), time in bed (TIB), sleep efficiency (SE), oxygen saturation (SaO2) and apnea-hypopnea index (AHI) for 5 consecutive nights.

               

               

                  Results

                  All enrolled participants (N=9) completed 5 days with no missing data. The sample was 66% female with an average age of 60±12 (Mean ± SD). Mean NPS scores indicated moderate pain intensity (6.3±1.9). Participants spent an average of 8.0±1.4h TIB and slept for 5.4+/-1.3h TST resulting in a SE of 68.5±17.9%. On average, AHI was 7.3±7.7 (mild range for sleep apnea). 56% of participants displayed a SaO2 nadir below 88%, the recommended threshold for supplemental oxygen. All individuals agreed that they were at least somewhat satisfied with the ease and amount of time participating in the study. All agreed or strongly agreed that they felt comfortable participating.

               

               

                  Conclusion

                  Participants used the disposable sleep test device at home with relative ease as indicted by complete data recording, values within expected norms, and satisfaction survey responses. The device could be an acceptable screening tool for sleep disorders and respiratory events that may otherwise go undetected in this population prescribed opioids and at risk for apnea and respiratory depression.

               

               

                  Support (if any)

                  NCATS/NIH # Ul1 TR002319 and The Rayce Rudeen Foundation

               },

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37278690,

title = {Neurocognitive predictors of adherence to an online pain self-management program adjunct to long-term opioid therapy},

author = {David E Fleck and Marian Wilson and Daniel Lewis and Jeffrey A Welge and Grace Arya and Anoop Sathyan and Kelly Cohen and T John Winhusen},

doi = {10.1080/13803395.2023.2221396},

issn = {1744-411X},

year  = {2023},

date = {2023-05-01},

journal = {J Clin Exp Neuropsychol},

volume = {45},

number = {3},

pages = {242--254},

abstract = {INTRODUCTION: While pain self-management programs can significantly improve patient outcomes, poor adherence is common and the need for research on predictors of adherence has been noted. A potential, but commonly overlooked, predictor is cognitive function. Our aim, then, was to examine the relative influence of various cognitive functional domains on engagement with an online pain self-management program.nnMETHOD: A secondary analysis of a randomized controlled trial testing the impact of E-health (a 4-month subscription to the online Goalistics Chronic Pain Management Program) plus treatment as usual, relative to treatment as usual alone, on pain and opioid dose outcomes in adults receiving long-term opioid therapy of morphine equivalence dose ≥20 mg; 165 E-health participants who completed an on-line neurocognitive battery were included in this sub-analysis. A variety of demographic, clinical, and symptom rating scales were also examined. We hypothesized that better processing speed and executive functions at baseline would predict engagement with the 4-month E-health subscription.nnRESULTS: Ten functional cognitive domains were identified using exploratory factor analysis and the resultant factor scores applied for hypothesis testing. The strongest predictors of E-health engagement were selective attention, and response inhibition and speed domains. An explainable machine learning algorithm improved classification accuracy, sensitivity, and specificity.nnCONCLUSIONS: The results suggest that cognition, especially selective attention, inhibitory control, and processing speed, is predictive of online chronic pain self-management program engagement. Future research to replicate and extend these findings seems warranted.nnCLINICALTRIALS.GOV REGISTRATION NUMBER: NCT03309188.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36525381,

title = {Opioid dose and pain effects of an online pain self-management program to augment usual care in adults with chronic pain: a multisite randomized clinical trial},

author = {Marian Wilson and Rowena J Dolor and Daniel Lewis and Saundra L Regan and Mary Beth Vonder Meulen and T John Winhusen},

doi = {10.1097/j.pain.0000000000002785},

issn = {1872-6623},

year  = {2023},

date = {2023-04-01},

journal = {Pain},

volume = {164},

number = {4},

pages = {877--885},

abstract = {Readily accessible nonpharmacological interventions that can assist in opioid dose reduction while managing pain is a priority for adults receiving long-term opioid therapy (LOT). Few large-scale evaluations of online pain self-management programs exist that capture effects on reducing morphine equivalent dose (MED) simultaneously with pain outcomes. An open-label, intent-to-treat, randomized clinical trial recruited adults (n = 402) with mixed chronic pain conditions from primary care and pain clinics of 2 U.S. academic healthcare systems. All participants received LOT-prescriber-provided treatment of MED ≥ 20 mg while receiving either E-health (a 4-month subscription to the online Goalistics Chronic Pain Management Program), or treatment as usual (TAU). Among 402 participants (279 women [69.4%]; mean [SD] age, 56.7 [11.0] years), 200 were randomized to E-health and 202 to TAU. Of 196 E-heath participants, 105 (53.6%) achieved a ≥15% reduction in daily MED compared with 85 (42.3%) of 201 TAU participants (odds ratio, 1.6 [95% CI, 1.1-2.3]; P = 0.02); number-needed-to-treat was 8.9 (95% CI, 4.8, 66.0). Of 166 E-health participants, 24 (14.5%) achieved a ≥2 point decrease in pain intensity vs 13 (6.8%) of 192 TAU participants (odds ratio, 2.4 [95% CI, 1.2-4.9]; P = 0.02). Benefits were also observed in pain knowledge, pain self-efficacy, and pain coping. The findings suggest that for adults on LOT for chronic pain, use of E-health, compared with TAU, significantly increased participants' likelihood of clinically meaningful decreases in MED and pain. This low-burden online intervention could assist adults on LOT in reducing daily opioid use while self-managing pain symptom burdens.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36175277,

title = {Piloting Smart Home Sensors to Detect Overnight Respiratory and Withdrawal Symptoms in Adults Prescribed Opioids},

author = {Marian Wilson and Roschelle Fritz and Myles Finlay and Diane J Cook},

doi = {10.1016/j.pmn.2022.08.011},

issn = {1532-8635},

year  = {2023},

date = {2023-02-01},

journal = {Pain Manag Nurs},

volume = {24},

number = {1},

pages = {4--11},

abstract = {BACKGROUND: Novel strategies are needed to curb the opioid overdose epidemic. Smart home sensors have been successfully deployed as digital biomarkers to monitor health conditions, yet they have not been used to assess symptoms important to opioid use and overdose risks.nnAIM: This study piloted smart home sensors and investigated their ability to accurately detect clinically pertinent symptoms indicative of opioid withdrawal or respiratory depression in adults prescribed methadone.nnMETHODS: Participants (n = 4; 3 completed) were adults with opioid use disorder exhibiting moderate levels of pain intensity, withdrawal symptoms, and sleep disturbance. Participants were invited to two 8-hour nighttime sleep opportunities to be recorded in a sleep research laboratory, using observed polysomnography and ambient smart home sensors attached to lab bedroom walls. Measures of feasibility included completeness of data captured. Accuracy was determined by comparing polysomnographic data of sleep/wake and respiratory status assessments with time and event sensor data.nnRESULTS: Smart home sensors captured overnight data on 48 out of 64 hours (75% completeness). Sensors detected sleep/wake patterns in alignment with observed sleep episodes captured by polysomnography 89.4% of the time. Apnea events (n = 118) were only detected with smart home sensors in two episodes where oxygen desaturations were less severe (>80%).nnCONCLUSIONS: Smart home technology could serve as a less invasive substitute for biologic monitoring for adults with pain, sleep disturbances, and opioid withdrawal symptoms. Supplemental sensors should be added to detect apnea events. Such innovations could provide a step forward in assessing overnight symptoms important to populations taking opioids.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38144708,

title = {Sleep and Pain in Veterans with Chronic Pain: Effects of Psychological Pain Treatment and Temporal Associations},

author = {Marian Wilson and Lillian Skeiky and Rachael A Muck and Megan A Miller and Devon A Hansen and Rhonda M Williams and Mark P Jensen and Hans P A Van Dongen},

doi = {10.2147/NSS.S418532},

issn = {1179-1608},

year  = {2023},

date = {2023-01-01},

journal = {Nat Sci Sleep},

volume = {15},

pages = {1061--1077},

abstract = {INTRODUCTION: Chronic pain is highly prevalent in US military Veterans. Non-opioid and non-pharmacologic treatments are recommended when clinically appropriate, but research on the mechanisms underlying benefits of these treatments is lacking. Here, we examined the role of sleep in the effects of three non-pharmacologic pain treatments in Veterans. Specifically, we investigated whether treatment effects on sleep predicted treatment effects on pain occurring later, or vice versa.nnMETHODS: Veterans enrolled in a randomized controlled trial were invited to participate in this supplementary sleep study. A total of 174 Veterans were randomized to one of three 8-session, in-person, group-based pain treatments: hypnosis, mindfulness meditation, or education control. Measurements included self-reported sleep disturbance, pain intensity, and pain catastrophizing; sleep duration was assessed with actigraphy. Sleep and pain measurements were obtained at baseline, posttreatment, and 3-month posttreatment follow-up.nnRESULTS: At baseline, average pain intensity was moderate (mean ± SD: 5.7 ± 1.7 on the 0-10 Numeric Rating Scale), pain catastrophizing was just below the clinically relevant threshold (mean ± SD: 28.6 ± 12.2 on the Pain Catastrophizing Scale), and subjective sleep disturbance exceeded the US population average (mean ± SD: 58.5 ± 8.1 on the Patient Reported Outcomes Measurement Information System Sleep Disturbance - Short Form). By contrast, objective sleep duration was consistent with the recommended daily sleep amount of 7-8 h for adults (mean ± SD: 8.3 ± 1.4 h). Across treatment conditions, pain intensity, pain catastrophizing, and subjective sleep disturbance were significantly less at posttreatment and 3-month follow-up than at baseline (p < 0.001). Actigraphic sleep duration did not differ significantly as a function of time. There was a high degree of covariation among the measures of pain intensity, pain catastrophizing, and sleep disturbance (p < 0.05). However, self-reported sleep disturbance was not significantly correlated with actigraphic sleep duration (|r| <= 0.13, p > 0.05). Sleep and pain variables observed at prior assessments predicted these same variables at subsequent assessments. There was no significant evidence that changes in pain preceded changes in sleep or that changes in sleep preceded changes in pain (all p > 0.05).nnDISCUSSION: For this study's Veterans, treatment-related changes in sleep and pain appeared to occur in parallel. The concomitant changes in sleep and pain suggest that therapies improving pain in Veterans may yield attendant benefits for the treatment of sleep, and possibly vice versa.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35393218,

title = {Hyperbaric Oxygen Therapy for Pain, Opioid Withdrawal, and Related Symptoms: A Pilot Randomized Controlled Trial},

author = {Marian Wilson and Ross J Bindler and Karen Stanek and Matthew E Layton and Raymond M Quock},

doi = {10.1016/j.pmn.2022.03.001},

issn = {1532-8635},

year  = {2022},

date = {2022-10-01},

journal = {Pain Manag Nurs},

volume = {23},

number = {5},

pages = {616--624},

abstract = {BACKGROUND: Pain, drug cravings, and opioid withdrawal symptoms can interfere with substance use disorder or opioid tapering treatment goals.nnAIM: This pilot study investigated the feasibility of a protocol designed to test opioid withdrawal symptom relief relative to a sham condition after two consecutive days of hyperbaric oxygen therapy (HBOT) for adults prescribed daily methadone for opioid use disorder.nnMETHOD: Using a double-blind protocol, eight adults were randomized to receive either a full 90-minute HBOT dose in a pressurized chamber with 100% oxygen at 2.0 atmospheres absolute (ATA) or a sham condition receiving 21% oxygen (equivalent to room air within the chamber) at a minimal pressure of ≤1.3 ATA. Measures included study retention, treatment satisfaction, and pre- and post-intervention effects for opioid withdrawal symptoms, drug cravings, pain intensity and interference, sleep quality, and mood.nnRESULTS: Study retention and treatment satisfaction was high. All measurements improved more, on average, for participants receiving full-dose HBOT treatment than among participants receiving sham treatments except for clinically observed withdrawal symptoms. The largest positive effects were observed in measurements of pain intensity and drug craving.nnCONCLUSIONS: These pilot results provide evidence to support a fully powered study of HBOT as a potential treatment adjunct for adults receiving methadone for opioid use disorder. Trends towards symptom improvements were detected from pre- to post-HBOT in the full treatment arm versus sham condition. More research into novel non-pharmacologic options to relieve distressing symptoms related to pain and opioid use disorder is essential to improve clinical outcomes.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34432530,

title = {Ask Your Provider About Cannabis: Increasing Nurse Practitioner Knowledge and Confidence},

author = {Tracy A Klein and Ross Bindler},

doi = {10.1089/can.2021.0061},

issn = {2378-8763},

year  = {2022},

date = {2022-10-01},

journal = {Cannabis Cannabinoid Res},

volume = {7},

number = {5},

pages = {700--705},

abstract = { Nurse practitioners (NPs) are authorizing providers for medical cannabis in many states, and may serve as a primary care clinician. We report findings from a nationally distributed 2-h continuing education (CE) module aimed to improve knowledge, confidence, and willingness to communicate with patients about cannabis.  Data were electronically obtained from the CE platform pre- and post-test (=289) and a follow-up survey sent within 3 months postcompletion (=184, 63%). Pre- and post-testing assessed cannabis pharmacodynamics, law, evidence-based use, metabolism, pharmacokinetics, laboratory testing, adverse reactions, and drug-drug interactions. The subsequent survey asked about changes in practice behavior, including willingness and self-identified recommendations for use. Quantitative and qualitative descriptive analysis and repeated-measures analysis of variance were used to analyze CE impact.  Significant improvement in scores was noted from pretest to post-test for all content with a mean improvement of 39.3% (95% CI: 30.6-47.9%). The greatest increases were for metabolism, pharmacokinetics, and drug-drug interaction content. At follow-up, 52.2% reported that the CE changed their attitudes about cannabis and although 86% had rarely or never applied it yet in practice, 92% reported they were now likely to inquire about cannabis use in their patients and 84% were likely to counsel patients about it. Although self-identified recommendations overlapped by conditions, some were unique to CBD (complex regional pain syndrome, migraine, mood disorder, smoking cessation) and THC products (appetite, cachexia, depression, fibromyalgia, HIV, seizure disorder, stress, and weight loss). Pain was the most common condition for recommendation of both CBD and THC, followed by anxiety and arthritis.  NPs gained key knowledge about cannabis, which may impact patient care and prescribing practices. The educational module resulted in more willingness to discuss and counsel patients about cannabis, even if practitioner attitudes did not change.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35898257,

title = {Drug-Drug Interaction Between Orally Administered Hydrocodone-Acetaminophen and Inhalation of Cannabis Smoke: A Case Report},

author = {Ross Jason Bindler and Christy J W Watson and Abram J Lyons and Lillian Skeiky and Jamie Lewis and Michael McDonell and Philip Lazarus and Marian Wilson},

doi = {10.1177/00185787211061374},

issn = {0018-5787},

year  = {2022},

date = {2022-08-01},

journal = {Hosp Pharm},

volume = {57},

number = {4},

pages = {518--525},

abstract = {OBJECTIVE: To determine if a 2-day protocol measuring pharmacokinetic and pharmacodynamic characteristics can demonstrate drug-drug interactions when smoked cannabis is added to orally administered hydrocodone/acetaminophen combination products.nnCASE SUMMARY: A 51-year-old non-Hispanic white male with chronic pain diagnoses participated in a 2-day pilot protocol. The participant attended two 7-hour in-lab days where he received 10 blood draws each day and completed self-administered pain and anxiety surveys. For both days, the participant took his prescribed dose of hydrocodone/acetaminophen (1/2 tablet of 7.5 mg/325 mg combination product) with the addition of 1 smoked pre-rolled marijuana cigarette (labeled as 0.5 g; 22.17% Δ9-tetrahydrocannabinol; 0.12% cannabidiol) on Day 2. Blood specimens were analyzed using mass spectrometry to quantify the difference of plasma hydrocodone levels between Day 1 and Day 2.nnRESULTS: Compared to Day 1, lower levels of pain and anxiety were reported during Day 2 with the addition of cannabis to oral hydrocodone/acetaminophen. Day 2 pharmacokinetic analysis also revealed more rapid absorption and overall lower levels of hydrocodone in plasma.nnDISCUSSION: Lower hydrocodone plasma levels in Day 2 may indicate cannabis's effect on metabolism and reduce the risk of opioid toxicity. The quicker absorption rate of hydrocodone could explain lower pain and anxiety scores reported on the second day.nnCONCLUSION AND RELEVANCE: A 2-day protocol was able to capture differences across time in pharmacokinetic and pharmacodynamic measurements. Larger studies can be designed to better characterize the potential drug-drug interaction of cannabis and opioids.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34965906,

title = {Pain Management and Risks Associated With Substance Use: Practice Recommendations},

author = {Helen N Turner and June Oliver and Peggy Compton and Deborah Matteliano and Timothy Joseph Sowicz and Stephen Strobbe and Barbara St Marie and Marian Wilson},

doi = {10.1016/j.pmn.2021.11.002},

issn = {1532-8635},

year  = {2022},

date = {2022-04-01},

journal = {Pain Manag Nurs},

volume = {23},

number = {2},

pages = {91--108},

abstract = {Assessing and managing pain while evaluating risks associated with substance use and substance use disorders continues to be a challenge faced by health care clinicians. The American Society for Pain Management Nursing and the International Nurses Society on Addictions uphold the principle that all persons with co-occurring pain and substance use or substance use disorders have the right to be treated with dignity and respect, and receive evidence-based, high quality assessment, and management for both conditions. The American Society for Pain Management Nursing and International Nurses Society on Addictions have updated their 2012 position statement on this topic supporting an integrated, holistic, multidimensional approach, which includes nonopioid and nonpharmacological modalities. Opioid use disorder is used as an exemplar for substance use disorders and clinical recommendations are included with expanded attention to risk assessment and mitigation with interventions targeted to minimize the risk for relapse or escalation of substance use. Opioids should not be excluded for anyone when indicated for pain management. A team-based approach is critical, promotes the active involvement of the person with pain and their support systems, and includes pain and addiction specialists whenever possible. Health care systems should establish policies and procedures that facilitate and support the principles and recommendations put forth in this article.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Gray2022,

title = {Experiences of Pain in Adults Receiving Methadone for Opioid Use Disorder},

author = {Emily A. Gray and Ross J. Bindler and Marian Wilson},

doi = {10.1016/j.pmn.2022.02.039},

issn = {1524-9042},

year  = {2022},

date = {2022-04-00},

journal = {Pain Management Nursing},

volume = {23},

number = {2},

publisher = {Elsevier BV},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35306565,

title = {Pain Catastrophizing Mediates the Relationship Between Pain Intensity and Sleep Disturbances in U.S. Veterans With Chronic Pain},

author = {Marian Wilson and Lillian Skeiky and Rachael A Muck and Kimberly A Honn and Rhonda M Williams and Mark P Jensen and Hans P A Van Dongen},

doi = {10.1093/milmed/usac065},

issn = {1930-613X},

year  = {2022},

date = {2022-03-01},

journal = {Mil Med},

volume = {188},

number = {7-8},

pages = {e2639--e2645},

abstract = {INTRODUCTION: Veterans with chronic pain frequently report comorbid disruptions in sleep and psychological dysfunction. The purpose of this study was to investigate whether psychological function variables mediate the sleep-pain relationship. Knowledge regarding such contributing factors can inform the development and optimization of treatments for sleep disturbances and pain.nnMATERIALS AND METHODS: In an IRB-approved, registered clinical trial, we collected objective sleep data from U.S. military Veterans with chronic pain (N = 184, ages 23-81) using wrist actigraphy for 7 days and self-reported survey data assessing sleep quality, pain intensity, and psychological function (depression, anxiety, post-traumatic stress disorder, and pain catastrophizing). We investigated the associations between objectively measured and self-reported sleep quality and self-reported pain intensity. In addition, using parallel mediation analyses, we examined whether psychological function variables mediated these associations.nnRESULTS: Actigraphy showed suboptimal sleep duration (less than 7 hours) and sleep fragmentation for most participants. Self-reported poor sleep quality and pain intensity were significantly correlated. Pain catastrophizing was found to mediate the association between self-reported sleep quality and pain intensity.nnCONCLUSIONS: Sleep disturbances in this sample of Veterans with chronic pain included insufficient sleep, fragmented sleep, and perceived poor sleep quality. Analyses suggest that poor perceived sleep quality and pain intensity are mediated via pain catastrophizing. The finding highlights the potential importance of pain catastrophizing in Veterans with chronic pain. Future longitudinal research is needed to determine the extent to which treatments that reduce pain catastrophizing might also improve both sleep and pain outcomes.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33139204,

title = {Shared Decision-Making for Patients Using Cannabis for Pain Symptom Management in the United States},

author = {Marian Wilson and Tracy Klein and Ross J Bindler and Louise Kaplan},

doi = {10.1016/j.pmn.2020.09.009},

issn = {1532-8635},

year  = {2021},

date = {2021-02-01},

journal = {Pain Manag Nurs},

volume = {22},

number = {1},

pages = {15--20},

abstract = {OBJECTIVES: Gaps in research evidence and inconsistent policies regarding use of cannabis for pain and associated symptoms result in confusion for healthcare providers and patients. The objective of this review was to synthesize information on cannabis use for pain with legal and policy implications to create a shared decision-making model that can be used to guide patient care interactions.nnAPPROACH: Current cannabis policies, state laws, research, and patient care practices related to medical and recreational cannabis in the United States were reviewed, along with best practices in shared decision-making. Reviewed literature was then synthesized to create a model that can be used by registered nurses and others to address cannabis use, where legal, for pain and related symptoms.nnRESULT AND CONCLUSIONS: Cannabis is a legal option for many patients with pain. To minimize harms and optimize benefits, nurses can play a key role when authorized by law in assisting with decision-making surrounding cannabis use.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36857542,

title = {Pain Management and Substance Use Disorders: A Position Statement},

author = {Timothy Joseph Sowicz and Peggy Compton and Deborah Matteliano and June Oliver and Stephen Strobbe and Barbara St Marie and Helen N Turner and Marian Wilson},

doi = {10.1097/JAN.0000000000000506},

issn = {1548-7148},

journal = {J Addict Nurs},

volume = {34},

number = {1},

pages = {5--7},

abstract = {The American Society for Pain Management Nursing and the International Nurses Society on Addictions hold the position that persons with co-occurring pain and substance use disorder have the right to be treated with dignity and respect and receive evidence-based, high-quality assessment and management for both conditions using an integrated, holistic, multidimensional approach. Nonopioid and nonpharmacological approaches to pain management are recommended. Opioids should not be withheld from anyone if necessary to treat pain, and a team-based approach, including pain and addiction specialists, should be utilized when possible. Pain management should include interventions aimed at minimizing the risk for relapse or escalation of problematic substance use and actively involve the person and their support persons in the plan of care. Institutions should establish policies and procedures that support this position statement.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}