Satisfaction with Life among Recipients of Opiate Substitution Treatment

Objective: Opiate substitution treatment aims at restoring an adequate satisfaction in life. We evaluated to what extent chronic pain and concurrent substance abuse interfere with this goal.

Method: Sixty patients (mean age 37.9, SD=9.3; 32 males, 28 females) underwent urine tests for cocaine, benzodiazepines, oxycodone, and for other opiates, and completed Pavot’s Temporal Satisfaction With Life Scale (TSWLS). This scale consists of 15 items of which 5 assess the satisfaction with one’s past, 5 with the present, and another 5 with the future. The patients also completed 3 items from the Brief Pain Inventory (scales from 0 = no pain to 10 = extreme pain) to assess their average level of pain, the worst pain, and the least pain.

Results: Only 4 patients (6.7%) rated their worst pain at zero, i.e., as absent. The average pain in this sample was 4.2 (SD=2.7), the worst pain 6.3 (SD=3.2), and the least pain 2.6 (SD=2.3). Our patients’ average satisfaction score (59.8, SD=19.6) was significantly lower than in Pavot’s normative sample of 294 adults (70.8, SD=14.8, t=4.1, df=72.8, p<.001). A significant inverse correlation (r=-.31, p=.008) was found between the total satisfaction score and the sum of all pain ratings. About a third of the patients (34.5%) still abused illicit drugs. The satisfaction score was not significantly related to concurrent substance abuse determined by urine toxicology tests (p>.05). These patients’ satisfaction with current life was significantly higher than with their past (t=2.4; df=59; p=.020).

Discussion: Although our patients’ satisfaction with their current life was higher than in the past, their satisfaction with current life remains significantly below normal, i.e., below data from Pavot’s normative sample. Almost all patients (93.3%) reported the presence of pain as shown by the rating above zero on the “worst pain” scale of Cleeland’s Brief Pain Inventory.

Conclusions: Pain is prevalent among our patients and its management remains an important clinical issue. The pain has a significant impact on the patients’ well-being by reducing their overall satisfaction with life.

Keywords: pain, addiction, opiates, methadone, urine toxicology, satisfaction with life.