Exploring chronic pain and other clinical characteristics in drug treatment court participants

Subst Abuse Treat Prev Policy. 2026 Jun 11. doi: 10.1186/s13011-026-00740-7. Online ahead of print.

ABSTRACT

BACKGROUND: Three out of four participants in Drug Treatment Courts (DTCs) present with co-occurring substance use disorders and mental health disorders (COD). Among individuals with COD outside criminal-legal settings, 71% report chronic pain. However, chronic pain has not been examined in the context of DTC participation. This secondary analysis compared intake treatment needs of DTC participants with COD, stratified by presence or absence of chronic pain history.

METHODS: Participants with COD from five DTCs were compared: 61 with chronic pain history (36%) and 109 without (64%). Chronic pain history was defined based on self-reported lifetime chronic pain and/or receipt of prescriptions for chronic pain management. Bivariate analyses compared pain, mental health, alcohol and illicit substance use, criminal-legal, and quality of life factors.

RESULTS: Participants with chronic pain history reported greater pain severity and pain-related interference with enjoyment and daily activities. A higher proportion of participants with chronic pain history (66%) reported non-medical prescription opioid use compared to those without chronic pain history (16%). They also reported more illicit use of oxycodone (0.05 vs. 0), more opioid overdoses (0.12 vs. 0), and fewer nights in jail (23.50 vs. 54.16). No significant differences emerged in mental health or quality of life.

CONCLUSIONS: This work is the first to compare treatment needs of DTC participants with and without chronic pain history, and the sample presented with a high prevalence of chronic pain history. Therefore, DTC programs should assess for chronic pain among participants to incorporate pain management and support participants more effectively.

PMID:42277872 | DOI:10.1186/s13011-026-00740-7