Single-session, virtual, pain relief skills class for adults with chronic pain on long-term opioids: A randomized controlled trial.

Behavioral pain treatments are recommended as best practice for chronic pain management, yet remain understudied in people taking long-term opioids despite the critical need to develop effective non-pharmacological approaches for this vulnerable population. A randomized controlled trial tested whether a single-session, Zoom-delivered pain relief skills class (Empowered Relief; ER) lowers opioid use in adults with chronic pain receiving long-term opioid therapy. Two hundred thirteen participants (79 % women; median morphine equivalent daily dose 68 mg; 59% on disability; 26 % with prescription opioid misuse) were allocated 1:1 to one of two interventions: ER or an attention-matched health-education control- with both interventions taught by instructors involved in prior trials showing efficacy. Outcomes were assessed at baseline, 1, and 3 months. The primary endpoint, self-reported opioid dose at 3 months, showed no between-group difference (median change -2 mg vs -1 mg, P = 0.73) and no significant time effect. Pain interference likewise remained unchanged. Across groups, modest improvements appeared in pain intensity (mean -0.6/10, 95 % CI -0.9 to -0.3) and pain catastrophizing (-1.4/52, 95 % CI -2.4 to -0.4). The skills class produced greater gains in PROMIS Global Mental Health than control (group × time β = 1.2, P = 0.007), and participant satisfaction was higher (96 % vs 82 % rating ≥ 8/10). Attendance exceeded 85 %, and no adverse events occurred. ER is feasible and acceptable but insufficient to reduce opioid dose; integration with clinician-guided tapering protocols warrants study. ClinicalTrials.gov NCT03950791. PERSPECTIVE: Despite prior success in non-opioid and opioid samples, a two-hour telehealth pain relief skills class did not lessen opioid use in this complex opioid-treated cohort, though it modestly improved mental health. The findings suggest population-specific factors matter, and that brief behavioral training should be embedded within broader, taper-supportive care pathways, when opioid reduction is the goal.