Neuropsychoanalytic Treatment of Failed Back Surgery Syndrome-Opioid Dependence

Patients were detoxified from opioid analgesics and treated with NSAIDs and other non-opioid analgesics, received neuropsychoanalytic therapy and low dose naltrexone. Patients kept a daily diary of: 0 - 10 pain, 0 - 10 function, hours worked, amount of alcohol drunk, illicit and licit drug use, number of health care provider appointments attended, number of self-help groups meetings attended across each of the six months of study. Six month outcomes of this approach with primary outcomes being sobriety, pain scores and function scores.

Inclusion criteria

• Have failed back surgery syndrome.
• Have evidence of Opioid Dependence by meeting DSM-IV criteria and by Drug Abuse Screening Test > 4. (In case of a difference in these two measures, clinical staff will talk with the patient to adjudicate the difference.)
• Over 18
• Be able to understand spoken and written English
• Reside within 30 miles of the site of treatment for ease of followup
• Have health insurance or other ability to pay for treatment

Exclusion criteria

• Homeless
• Unable to give consent (e.g. neurological disorders, dementia, psychosis)
• Co-occurring incapacitating psychiatric disorder such as schizophrenia
• Pregnant
• Financial incentive to stay ill, such as a pending disability claim
• Member of a vulnerable population, including prisoners