A Pilot Study of Preoperative Opioid Tapering Using Cognitive Behavioral Therapy and Education Before Spine Surgery and Measuring Postoperative Outcomes

What this Trial Is About

This research aims to evaluate opioid tapering methods in patients who are chronically using opioids and scheduled for spine surgery at least four weeks later. The study focuses on comparing opioid tapering with education alone versus opioid tapering combined with cognitive behavioral therapy (CBT). It addresses challenges faced by opioid-dependent patients in the perioperative period, including pain control difficulties and higher risks of complications and prolonged opioid use after spine surgery. Participants will be randomly assigned to one of two groups: one receiving opioid tapering with education alone, and the other receiving opioid tapering with education plus CBT. All patients will work with a pain physician to create a personalized tapering plan. The CBT group will have two sessions before surgery and one session after surgery via telemedicine. Both groups will receive education about opioid tapering, potential withdrawal symptoms, increased pain, and risks of opioids. Throughout the study, pain, depression, anxiety, and withdrawal symptoms will be assessed before and after surgery. Hospital outcomes like pain levels, opioid use, recovery quality, and complications will be tracked. Follow-up assessments will be conducted at 30, 90, 180, and 365 days after surgery via phone or Zoom to monitor pain, function, and opioid use. The primary outcome is the proportion of patients who reach their opioid tapering goals by the time of surgery.

Preoperative Opioid Tapering Before Spine Surgery