Knowledge and Attitudes Towards Use of Complementary and Integrative Health Therapies for Veterans with Opioid Use Disorder in the Veterans Health Administration

Abstract

The Veterans Health Administration (VA) offers complementary and integrative health (CIH) therapies to Veterans with chronic pain and opioid use disorder (OUD). While CIH therapies have known benefits for chronic pain, less research exists on its use for patients with OUD. In this qualitative study, we aimed to assess provider and patient perceptions of CIH therapies for Veterans with OUD. We interviewed 45 providers involved in OUD care and 17 Veterans with OUD from five VA medical centers as part of a larger mixed-methods evaluation. Interviewees were identified through a snowball sampling strategy. The interview guide used the Practical Robust Implementation and Sustainability Model to explore contextual factors influencing CIH therapy adoption (i.e., patient perspectives, provider perspectives, external environment). Most Veterans and providers were knowledgeable about CIH therapies and had positive experiences with them. Providers and Veterans said it was important to offer non-pharmacologic options for OUD. Some providers, however, felt that Veterans with OUD may be less likely than those with only chronic pain to consider CIH therapies due to more reported patient resistance and other barriers. Veterans with OUD and their providers were enthusiastic about integrating CIH therapies into treatment plans as a non-pharmacologic option for chronic pain and OUD. However, providers noted unique challenges impacting use of CIH therapies for Veterans with OUD. Providers may benefit from learning patient-centered approaches to offering CIH therapies to Veterans with OUD as part of a comprehensive pain treatment plan.