# Chronic Pain Management and Patient-Centered Outcomes Following Discontinuation of Long-Term Opioid Therapy

> **NIH VA I01** · PORTLAND VA MEDICAL CENTER · 2022 · —

## Abstract

Nearly 900,000 Veterans were dispensed opioid medication at the prescribing peak in 2012, with rates of
opioid prescribing in VA subsequently declining year-over-year to fewer than 700,000 Veterans dispensed
opioid medication in 2016. These downward trends are likely to continue with more widespread implementation
of the VA Opioid Safety Initiative, additional efforts at local VA hospitals to enhance opioid risk mitigation and
safe opioid prescribing practices, and recently released CDC and VA/DoD opioid prescribing guidelines that
discourage long-term opioid therapy for chronic non-cancer pain. Despite steady rates of opioid discontinuation
in VA, little is known about consequences—both positive and negative—of opioid discontinuation. The
objectives of this study are to characterize patients’ experiences with the opioid discontinuation process,
identify ways patients subsequently manage their pain through the use of VA and non-VA resources, and
examine patient-centered outcomes such as quality of life, pain, substance use, and mental health symptom
severity following opioid discontinuation. This prospective cohort study will enroll 1,144 VA patients randomly
selected from the population of VA patients prescribed long-term opioid therapy. All patients will complete 5
mailed or online survey assessments at baseline, 6-, 12-, 18-, and 24-month follow-up that assess quality of
life, pain, substance use, and mental health symptoms. Additional clinical and pharmacy data will be extracted
from patients’ VA electronic health record. We will monitor patients in the cohort for reductions in opioid dose
and complete opioid discontinuation. Patients who discontinue opioid therapy will complete an additional
survey to assess acute patient outcomes following opioid discontinuation. A subset of 40 patients who
discontinue opioid therapy will participate in semi-structured interviews over the telephone immediately
following discontinuation, as well as 6- and 12 months post-discontinuation. Interviews will ascertain patients’
experiences with the opioid discontinuation process, pain treatment approaches utilized within and external to
VA, and patient outcomes following discontinuation. This study has three specific aims: (1) compare acute
(immediate), intermediate (6-month), and long-term (12-month) quality of life and pain outcomes between
patients who discontinue versus those who remain on long-term opioid therapy (LTOT), (2) test the moderating
effect of gender and race/ethnicity on changes in quality of life and pain outcomes between patients who
discontinue versus those who remain on LTOT, and (3) use qualitative methods to augment quantitative
findings on patient quality of life and pain outcomes, identify patient experiences with the opioid discontinuation
process, and characterize the impact of discontinuation on patient-clinician relationships. The integration of
results from quantitative and qualitative data analyses will characterize patient experienc...

## Key facts

- **NIH application ID:** 10308452
- **Project number:** 5I01HX002518-04
- **Recipient organization:** PORTLAND VA MEDICAL CENTER
- **Principal Investigator:** Travis Ian Lovejoy
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-11-01 → 2024-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10308452

## Citation

> US National Institutes of Health, RePORTER application 10308452, Chronic Pain Management and Patient-Centered Outcomes Following Discontinuation of Long-Term Opioid Therapy (5I01HX002518-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10308452. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*