# Treating Chronic Pain in Buprenorphine Patients in Primary Care Settings

> **NIH NIH R01** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2021 · $757,372

## Abstract

ABSTRACT
Nearly half a million Americans receive buprenorphine for opioid use disorder (OUD). More than 40% of those
seeking treatment with buprenorphine have pain that interferes with daily activities and affects drug treatment
outcomes, yet no effective non-pharmacological therapies exist to improve pain outcomes. Developing a novel
pain treatment is complicated by the fact that among opioid dependent patients, pain often co-occurs with
depression. We developed a collaborative primary care approach, entitled TOPPS (Treating Opioid Patients’
Pain and Sadness), in which behavioral health specialists and primary care providers share a unified plan for
addressing pain and depression in patients receiving buprenorphine. The newly developed intervention
integrates and builds upon behavior therapy for chronic pain and depression with the aim of reducing
behavioral avoidance and increasing behavioral activation. In our pilot work, we demonstrated that TOPPS
meets standards of feasibility and preliminary efficacy and, building on our R34 findings, we now propose a
randomized controlled trial of TOPPS compared to a health education contact-control condition among 250
persons with OUD recruited from two primary care-based buprenorphine programs. We will provide both
interventions over three months and follow participants for a total of 12 months in order to observe both short-
term and longer-term effects of TOPPS. P
ain-related
interference with physical and psychosocial functioning
(“pain interference”), pain severity and depression will be the primary outcome variables assessed, and
buprenorphine treatment retention will be the secondary outcome variable. Our goal is for this research to
result in the incorporation into buprenorphine care of theoretically-driven, empirically-tested therapy for patients
with pain and depressive symptoms. We believe that TOPPS will lead to improved pain, depression, and
substance use outcomes, and can utilize providers available within buprenorphine programs, broadening the
disseminability of this novel intervention and heightening its public health impact nationally and internationally.

## Key facts

- **NIH application ID:** 10098313
- **Project number:** 5R01DA045695-03
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** Michael D Stein
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $757,372
- **Award type:** 5
- **Project period:** 2019-02-15 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10098313

## Citation

> US National Institutes of Health, RePORTER application 10098313, Treating Chronic Pain in Buprenorphine Patients in Primary Care Settings (5R01DA045695-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10098313. Licensed CC0.

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