Key Finding
Auricular acupuncture is incorporated as a key stress-reduction component in the highest tier of a stepped care model designed to reduce nonmedical opioid use and chronic pain in patients with opioid use disorder.
Chronic pain is a serious challenge for many people being treated for opioid use disorder (OUD). When pain goes unmanaged, it can make it harder to stay in treatment and easier to return to nonmedical opioid use. A new clinical trial called SC-POWR (Stepped Care for Patients to Optimize Whole Recovery) is exploring whether a layered, or "stepped," treatment approach can help people dealing with both conditions at the same time.
The study will enroll 316 participants who are currently on medications like buprenorphine or methadone for OUD and also live with chronic pain. Half will receive standard care — their medication plus regular counseling. The other half will receive standard care plus up to 12 sessions of cognitive behavioral therapy (CBT). If a person is not improving enough, their care gets "stepped up" to include group exercise sessions like Tai Chi and Nintendo Wii Fit, and later, stress reduction techniques including relaxation training and auricular acupuncture.
Auricular acupuncture — the stimulation of specific points on the outer ear — is included as one of the stress-reduction tools in the most intensive level of care. It has been used for decades in addiction recovery settings and is recognized for its calming, pain-relieving properties.
The trial will run for nearly a year total, tracking not just opioid use and pain levels, but also alcohol use, anxiety, depression, sleep quality, and how long people stay in treatment. Researchers are hopeful that this step-by-step approach will offer more personalized, effective care.
If you or someone you love is managing chronic pain and exploring integrative options like acupuncture, seek out a licensed, board-certified acupuncturist with experience in pain management or addiction support.
The SC-POWR trial is an NIH-funded randomized effectiveness study (n=316) evaluating a stepped care model for patients with comorbid opioid use disorder (OUD) and chronic pain (CP) on medication-assisted treatment (buprenorphine or methadone). Participants are randomized to treatment-as-usual (TAU) or SC-POWR, which initiates with up to 12 sessions of CBT over 24 weeks. Non-responders at week 6 are stepped up to group exercise interventions (Tai Chi, Wii Fit), and non-responders at week 15 receive weekly stress-reduction sessions incorporating relaxation training and auricular acupuncture. Primary outcomes include nonmedical opioid use and pain reduction; secondary outcomes encompass pain intensity and interference, alcohol use, anxiety, depression, stress, and sleep. A 24-week follow-up phase assesses durability and MOUD retention. Notably, auricular acupuncture is embedded as a third-tier therapeutic component, reflecting growing clinical interest in its role within integrative addiction and pain protocols. No effect size data are yet reported, as this is a prospective trial registration.
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