RecruitingNot ApplicableNCT07221786

Preoperative Opioid Tapering Before Spine Surgery

A Pilot Study of the Feasibility of Preoperative Opioid Tapering Before Spine Surgery Using Cognitive Behavioral Therapy and Measuring Postoperative Outcomes

Sponsor

Thomas Jefferson University

Enrollment

45 participants

Start Date

Dec 1, 2025

Study Type

INTERVENTIONAL

Conditions

Opioid Consumption, Postoperative Pain After Surgery Opioid Dependency

Summary

This is a pilot study in which patients taking opioids chronically who are scheduled for spine surgery at least 4 weeks in advance will be randomly assigned to one of two groups: opioid tapering with education alone or opioid tapering with education plus cognitive behavioral therapy (CBT). The primary objective is to determine the proportion of each group that is successful in achieving their opioid tapering goals by the time of surgery.

Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This study is testing whether a structured opioid tapering program before major spine surgery can reduce complications and improve recovery. Patients who take opioids long-term before surgery are known to have worse outcomes, and this study aims to help them safely reduce their dose before going under the knife. **You may be eligible if...** - You are 18 or older - You are scheduled for major spine surgery (fusing at least 2 levels) at least 4 weeks from now - You currently take between 40 and 200 morphine equivalents of opioids daily **You may NOT be eligible if...** - You cannot use a computer or tablet for video appointments - You do not speak English - You cannot complete the required assessments - You screen positive for significant suicide risk Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

OTHEROpioid tapering with CBT and education

Patients in the opioid tapering plus CBT group will set up an initial meeting with the pain physician within a few days of enrollment to set the tapering schedule. They will also have two CBT appointments set up to complete via telemedicine during the time between enrollment and surgery.

OTHEROpioid tapering with education alone

Patients in this group will be instructed to continue their opioids at the same doses and frequencies they were taking up through the day of surgery. They will set up an initial meeting within a few days of enrollment with the chronic pain physician to determine the tapering schedule which will occur over 4 weeks or more leading into surgery. The patient and pain physician will collectively agree on a tapering schedule.

Locations(1)

Thomas Jefferson University Hospital

Philadephia, Pennsylvania, United States

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NCT07221786

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