Effectiveness of 2 behavioral interventions for voluntary opioid dosage reduction in patients prescribed high-dosage opioids for chronic pain

Pain 2026

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Authors: Mark J. Edlund, Sonia M. Thomas, Shawn Hirsch, Samantha Chang, Georgiy Bobashev, Laura K. Wagner, Jessica E. Thompson, Li-Tzy Wu ScD, Rowena J Dolor, Janis Curtis, Padma Gulur, Paul R. Chelminski
+10 more Timothy J. Ives, A O Goldstein, Susan Trout, Kristin R. Archer, Parul Goyal, Lindsey C. McKernan, Fred Wells Brason, Mark D. Sullivan, Lauren McCormack, for the INSPIRE Study Team
DOI: 10.1097/j.pain.0000000000003985
Cited by: 1
References: 36

Abstract

ABSTRACT: Studies of behavioral interventions for opioid reduction, which have included individuals prescribed low-, moderate-, and high-dosage opioids for chronic noncancer pain, generally show small to no effect on opioid dosage. We compared the effectiveness of motivational interviewing plus cognitive behavioral therapy (MI + CBT) vs shared decision-making (SDM) on change in opioid dosage in a large pragmatic randomized trial. This study is a secondary analysis examining subgroup differences between participants prescribed high-dosage opioids (≥90 morphine milligram equivalents [MME])-who are at the highest risk for adverse events-and those prescribed lower dosages (

Fields of Study & Subjects

Opioid Use Disorder Treatment Pain Management and Placebo Effect Substance Abuse Treatment and Outcomes

Publication details

Journal / source
Pain
Publisher
Ovid Technologies (Wolters Kluwer Health)
Volume
167
Issue
6
Pages
e170–e179
Publication date
14 May 2026
Language
EN