J Gen Intern Med. 2026 Oct 26. doi: 10.1007/s11606-026-10927-0. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic pain, opioid use disorder (OUD), and opioid misuse (OM) often appear as co-occurring conditions; however, they are infrequently treated simultaneously which may lead to worse health outcomes. A novel way to manage these co-occurring conditions is by using a pain self-management (PSM) approach, which focuses on changing behavior through mechanisms that focus on self-regulation. Behavioral interventions, such as PSM, are a safe and effective approach to chronic pain treatment and have the highest likelihood of impact when they are tailored to the target population and setting.

OBJECTIVE: The purpose of this study was to determine how to tailor PSM for patients with co-occurring chronic pain and OUD/OM.

DESIGN: Qualitative study, pragmatic clinical trial.

PARTICIPANTS: Patients with chronic pain and OUD/OM (N = 31) and clinicians/staff (N = 15) from primary care settings in Pennsylvania and West Virginia were interviewed to gather information needed to develop and tailor a PSM intervention.

INTERVENTIONS: Pain self-management.

APPROACH: Interviews were predominantly conducted remotely and addressed thoughts about pain, pain management, and the usefulness of behavioral interventions. Interviews were transcribed verbatim and coded using an inductively developed codebook; upon completion of coding, conventional content and thematic analysis was conducted.

KEY RESULTS: Results of participant interviews included key takeaways such as the risks of long-term opioid therapy, lack of pain self-efficacy, and the complex patient-provider relationships that arise during treatment of these co-occurring conditions. Clinicians/staff interviews discussed social determinants of health and stigma that can hinder clinicians from providing proper care.

CONCLUSIONS: The qualitative findings described from this pragmatic clinical trial allowed for the precise formulation of a PSM intervention that specifically targets patients with chronic pain and OUD/OM and may be relevant to the future development of other psychosocial-based interventions.

PMID:42934354 | DOI:10.1007/s11606-026-10927-0

J Palliat Med. 2026 Oct 25:10966218261499025. doi: 10.1177/10966218261499025. Online ahead of print.

ABSTRACT

Opioid therapy is a key component of palliative care delivery but may sometimes be associated with complications such as nonmedical opioid use (NMOU) behavior. Clinicians are encouraged to adopt risk-mitigation strategies to minimize NMOU while optimizing opioid prescribing practices. Urine drug testing (UDT) is usually implemented in palliative care (PC) settings to mitigate such risks, but its role is not well-defined. In this article, a group of PC specialists with specific clinical and research interests and expertise in UDT offers 10 tips regarding the current evidence surrounding UDT, its appropriate application, interpretation of results, and the utilization of test results within the PC context. The goal is to inform practicing PC clinicians regarding the use of UDT in routine opioid therapy.

PMID:42927981 | DOI:10.1177/10966218261499025

J Palliat Med. 2026 Oct 19:10966218261499456. doi: 10.1177/10966218261499456. Online ahead of print.

NO ABSTRACT

PMID:42897829 | DOI:10.1177/10966218261499456

J Subst Use Addict Treat. 2026 Oct 18:210140. doi: 10.1016/j.josat.2026.210140. Online ahead of print.

ABSTRACT

The National Institute on Drug Abuse Clinical Trials Network (CTN) was established in 1999 to bridge the persistent divide between addiction research and clinical practice through partnerships between researchers and community treatment providers. This editorial examines the evolution of the CTN over its first 25 years and considers priorities for its future. Drawing on the historical development of the Network and articles in this 25-year special collection, we examine changes in the populations and settings represented in CTN research, the incorporation of implementation science, the evolution of community partnerships, the scientific value of accumulated CTN data and experience, and emerging clinical and methodological priorities. Over 25 years, the CTN has developed from a network focused principally on clinically relevant effectiveness trials into a broader national infrastructure for clinical trials and translational addiction research. Its research has expanded beyond specialty addiction treatment programs into primary care, emergency departments, hospitals, community health centers, pharmacies, and other settings in which people with substance use disorders receive care. The Network has also increasingly addressed populations historically underrepresented in addiction research, incorporated implementation questions into clinical research, strengthened community engagement, and used accumulated trial data and emerging analytic methods to generate new scientific knowledge. These developments demonstrate that the value of a clinical research network extends beyond individual trial outcomes. Clinical trials should remain at the core of the CTN’s scientific mission. However, trial designs and complementary research methods should be determined by the scientific questions being addressed. The CTN’s future impact will depend on its ability to conduct rigorous multisite trials while incorporating implementation, representation, community partnership, and accumulated data and responding rapidly to changes in the drug supply and addiction care environment. These capabilities can help the Network generate evidence that is rigorous, relevant, timely, and more likely to improve addiction care.

PMID:42893770 | DOI:10.1016/j.josat.2026.210140