Frequently Asked Questions

There are three treatments being offered though the study:

  1. Patient-Centered Opioid Taper (PCOT)
  2. Cognitive Behavioral Therapy for Chronic Pain (pain-CBT)
  3. Chronic Pain Self-Management Program (CPSMP)

You will receive one of the following groups:

  1. Patient-Centered Opioid Taper – only
  2. Patient-Centered Opioid Taper + Cognitive Behavioral Therapy for Chronic Pain (in addition to the taper program, participants go through pain-CBT)
  3. Patient-Centered Opioid Taper + Chronic Pain Self-Management Program (in addition to the taper program, participants go through CPSMP)

 The Chronic Pain Self-Management program helps you gain skills and tools for managing your pain so that you can do the things you can do the things you want and need to do. You will learn from other like you and also have the opportunity to help others with your experiences. 

Both Pain-CBT and the CPSMP will be in a group-class format and led by a trained professional (e.g., a trained psychologist or mental health professional for Pain-CBT & 2 trained peer-leaders for the CPMSP). Professionals involved in oversight of program progress are the project core manager (Eric Dixon), primary investigator (Dr. Beth Darnall), and site directors. 

Both groups will help you learn self management skills to lessen pain and have a more positive and active life.

The primary difference between pain-CBT and the CPSMP, is that pain-CBT is led by a trained psychologist or mental health professional, while the CPSMP is led by two trained peer leaders who have lived experience with utilizing the techniques of the CPSMP for management of their own chronic pain. The duration of pain-CBT is eight weeks. The duration of the CPMSP is six weeks. 

CBT is lead by a trained psychologist or mental health professional while CPSMP is usually led by trained peer leaders who have lived experience with pain. 

CBT is eight weeks for 2 hours a week and CPSMP is six weeks for 2.5 hours a week

Yes, going to the groups is a very import part of the study. Of course things sometimes get in the way and you can still stay in the study even if you miss a week or two. If you are (or know you will be) absent from a class, you can contact the treatment provider for information covered during that class.

No, one of the things we are studying is how helpful the groups are for reducing your pain and opioid use. We will tell you what group to attend based on random order (chance).    

You will be in the study 12 months. Tapering your opioids will probably last six to nine months but may be more or less. You will attend a group within a month or two of entering the study.

  1. You can always contact the study coordinator with any  questions related to the study.
  2. You can contact your doctor or prescriber with medical questions between your regularly scheduled appointments which will be every three or so weeks.
  3. If you take a group, you will have the support of others in your group as well as your group leader.

Opioid Taper Questions

You will be in regular contact with medical professionals throughout your taper process. If assigned to pain-CBT or the CPSMP, you will be in regular contact with the treatment provider. You will also be learning ways to self-manage your pain, during the treatment classes.

This is referred to as plateauing and it is expected to be part of taper plans. Not everyone will necessarily have plateaus as part of their plan, but it is okay for them to occur.

Tapers are expected to last 6 to 9 months; however, tapers may last for the duration necessary for success, which can be less than 6 months or as long as 12 months.
You will be encouraged to have a follow-up appointment every three weeks or as necessary. Follow-up appointments may be with other health care professionals trained on the study protocols.
The taper plan is something that you and your prescriber will create together. It can be adjusted throughout the study as needed, by your prescriber. Importantly, your participation in the taper program is voluntary.
No. The goal is to get you to the lowest comfortable dose of your opioid medication and only one medication will be tapered during participation with the study.
For many people, the answer is yes, you can live without opioids! Opioids have serious health risks and new research tells us that for most people they are not the best way to treat long-term pain. In fact, after several months of use, they are likely not even helping your pain. Your body just gets used to them so you feel worse when you do not take them. Scientific studies show that if we reduce opioids the right way, patients do not have more pain. Scientific studies have also found that both Pain-CBT and the CPSMP are effective treatments for self-management of chronic-pain. The skills taught in the classes will help you to better self-manage your pain, improve quality of life, and importantly be less reliant on medications for relief. Specifically, the behavioral treatments in our study have been found to reduce pain intensity, pain bothersomeness, pain catastrophizing, pain interference with activities, social isolation, anxiety, and depressive symptoms, in addition to improving satisfaction with life, positive mood, and sleep quality.
No. Participation with the study will not depend on which opioid medication you are taking. In some cases, those wishing to taper off buprenorphine may participate.
Your taper plan will be designed for outpatient tapering (i.e., tapering at home) with regular follow-up appointments occurring approximately every three weeks or as necessary.

General Study Questions

Over the 12 months of participation with the study, participants will be expected to:  
  • Create a slow opioid taper plan with their prescriber 
  • Complete questionnaires: 
    • Weekly for the first 6 months 
    • Monthly for the last 6 months 
  • Attend as many treatment classes as possible (if assigned to pain-CBT or CPSMP) 
  • Attend follow-up appointments with prescriber, to ensure the taper is going as smoothly as possible. 

There are six different study sites across the United States: 

  1. Stanford Pain Management Center, Redwood City, CA 
  2. Stanford Primary Care, Santa Clara, CA 
  3. Stanford Primary Care at Hoover Pavilion, Palo Alto, CA 
  4. Phoenix VA Health Care System, Phoenix, AZ 
  5. Intermountain Health, Layton UT 
  6. Richard Stieg, M.D., LLC, Frisco, CO 

For contact information and directions, click here.

  • Participation with the study is 12 months.  
  • Pain-CBT (if assigned) consists of a 2-hour class  (Once per week for eight weeks, beginning within the first six weeks of study enrollment) 
  • The CPMSP (if assigned) consists of a 2.5-hour class  (Once per week for six weeks, beginning within the first six weeks of study enrollment) 
  • Weekly follow-up surveys are sent out during the first six months  (Average time to complete: 12 minutes) 
  • Monthly follow-up surveys are sent throughout the 12 months of participation (Average time to complete: 40 minutes) 
  • During your taper, you will be encourage to have a follow-up appointment every three weeks or as needed. 
There is no cost to participate in the study. If assigned to either pain-CBT or the CPSMP, those treatments are provided free of charge. Note, the study does not cover the costs of medical appointments scheduled/attended during your participation.
Amazon gift cards are provided for survey completion.
If your current doctor is a trained prescriber with the EMPOWER Study, then that doctor will manage your taper. If your current doctor is not a trained prescriber with the EMPOWER Study, then you will need to be referred to an EMPOWER Study-trained prescriber for management of your taper. Your current doctor will still be your primary care physician.
  • We will collect survey information from you, regarding your weekly and monthly experience during study participation. Surveys will go over medications you are taking, sleep quality, mood assessments, withdrawal symptoms, experience with treatments, life satisfaction, pain intensity, and demographics. 
  • Part of our screening process involves asking about illegal drug use. The responses to questions concerning illegal drug use could be self-incriminating and harmful to you if they became known outside the study. As explained in the confidentiality statement of the consent form, we do not intend to disclose this information.  
  • It is possible that based on information gained from this study, the researchers may have serious concerns (relating to matters such as severe depression, physical abuse, etc.) about your health and/or safety; in such a case, the researchers may contact you and provide a referral for your care. Additionally, the researchers may be required to report information (e.g., information relating to suicide, physical or sexual abuse) to the appropriate authorities. 
  • The results of this research study may be presented at scientific or medical meetings or published in scientific journals.  Your identity and/or your personal health information will not be disclosed except as authorized by you or as required by law.  However, there is always some risk that even de-identified information might be re-identified.  
  • Patient information may be provided to Federal and other regulatory agencies as required.  The Food and Drug Administration (FDA), for example, may inspect research records and learn your identity if this study falls within its jurisdiction.
You may drop out/withdraw your participation at any time. Participation is voluntary.
EMPOWER Study funding is provided by the Patient-Centered Outcomes Research Institute (PCORI).
If assigned to pain-CBT or the CPSMP, you will be taught ways to self-manage your pain, including when you experience pain flares (i.e., when your pain increases temporarily).
We plan to enroll 865 participants across all six of our study sites.
The patient-centered opioid taper is something you will create with your prescriber and have follow-up appointments for approximately every three weeks. If assigned to either pain-CBT or the CMPSMP, those are group treatment classes to attend once per week for 6-8 weeks with other participants.
Insurance is specific to the site you are receiving care from and is not related to the study. For example: Insurance will factor into coverage for appointments with your prescriber, as that is considered usual care, but participation in the study is free of charge (i.e., you are still responsible the costs or co-payments for medical appointments but you will not be charged to attend pain-CBT or the CPSMP if assigned to one).
The goal of study is to get you to the lowest comfortable dose of opioid medication possible within a 12-month period. If it is your goal to be completely off your opioid medication, that will be factored into the taper plan created by you and your prescriber.
The EMPOWER Study is a five-year study. Results will be analyzed by January 2023.

Potential benefits from the program are: 

  • Learning proven self-management skills for chronic-pain 
  • Experiencing less pain 
  • Reducing your opioid dosage while minimizing withdrawal symptoms 
  • Receiving care and support throughout your participation 
  • Being on a lower dose of opioid medication for chronic-pain management (if not being completely off opioids) 
  • Experiencing less side-effects from opioid medications and gaining more functionality in and satisfaction with life
This is the first program to study how effective pain-CBT and the CPSMP are in helping patients reduce their opioid medications. The study based on a recent taper plan found to increase success of opioid tapering and minimize withdrawal symptoms experienced during the taper process.

There are two control groups for the study: 

  1. Those assigned only to the patient-centered opioid taper 
  2. Those who enroll in the observational study. The observational study will track identical outcomes (surveys) for participants who choose not to participate in the patient-centered opioid tapering portion of the study. (Those in the observational study will not be assigned to pain-CBT or the CPSMP)
No. As the purpose of the study is to examine the efficacy of pain-CBT and the CPSMP in helping patients taper off opioids (or reduce their opioid dosage to a comfortable amount), all participants must currently be taking opioids for management of their chronic pain AND be voluntarily wanting to reduce their opioid dosage.

Complementary and alternative treatments with the study are: 

  • Cognitive Behavioral Therapy for Chronic Pain (Pain-CBT) 
  • The Chronic Pain Self-Management Program (The CPSMP)