Acceptance and Commitment Therapy is Effective in Reducing Strong Opioid Use in a Patient with Chronic Pain after Spinal Cord Injury: A Case Study

Abstract Strong opioids are used for chronic pain conditions, often long‐term, to improve the overall quality of life. Psychological approaches, such as acceptance and commitment therapy (ACT), are effective in preventing long‐term opioid use. However, studies exploring their efficacy among patients who have used strong opioids over an extended period are lacking. We present a case concerning chronic pain following spinal cord injury wherein ACT sessions were conducted for a patient with long‐term use of strong opioids. The patient was a Japanese man in his 80s with chronic pain due to a spinal cord injury 12 years earlier, despite being treated with daily fentanyl patches. The patient underwent 11 ACT sessions spanning approximately 6 months, complemented by two follow‐up sessions. The fentanyl patch dose was reduced by the conclusion of the ACT. The patient had improvements in locomotive syndrome, anxiety, and pain catastrophizing after the intervention and at the follow‐up session, compared with the pre‐intervention phase. These results suggest that ACT might be effective in helping patients discontinue strong opioids after long‐term use.