*2.3. Participants*

Study participants were comprised of the 98 successful graduates of a multidisciplinary LTOT cessation program that commenced between October of 2017 and December of 2019. A total of 109 patients started the program, and 11 either voluntarily left or were referred to a higher level of care due to high acuity comorbidities diagnosed after admittance. Program inclusion criteria were: adult-aged patients who voluntarily enrolled for the purpose of LTOT cessation due to lack of satisfaction with pain control, medication effects, and/or functional capacity while on LTOT. Participants were diagnosed with CNCP from any etiology; had used daily LTOT at the time of admission for a minimum of a year's duration (although most reported much longer use), or struggled to maintain recent opioid cessation after prolonged use; had previously tried and failed or plateaued in regards to opioid weaning. Program recruitment, exclusion criteria, and criteria for referral have been described elsewhere [14,30,31]. Long-term opioid therapy was defined as any form of prescribed oral or transdermal long- or short-acting pharmaceutical opioid obtained while under the care of a physician. At admission, participants used LTOT amounts as high as 600 daily oral morphine milligram equivalents (MME) (median, 60 MME; 25% quartile, 36.5 MME; 75% quartile, 90 MME; interquartile range, 53.5 MME) [30].

#### *2.4. Measures*

Standardized psychological questionnaires were given to each patient at the program orientation meeting and again at the program graduation. Each questionnaire was previously and independently validated. Table 1 lists and describes the application of the Epworth Sleepiness Scale (ESS) [32], the 36-Item Short Form Survey (SF-36) [33], the

Generalized Anxiety Disorder–7 Item Scale (GAD-7) [34], the Patient Health Questionnaire (PHQ) [35], the Fear Avoidance Belief Questionnaire-Physical Activity (FAB-PA) and Work (FAB-W) [36], the Tampa Kinesiophobia Scale (TSK) [37], the Pain Catastrophizing Scale (PCS) [38], and the Brief Pain Inventory-Pain Severity (BPI-Pain) and Impairment (BPI-Impairment) survey [39].

**Table 1.** Psychological assessment questionnaires.


Of note, additional data were gathered throughout the program for the separate analyses of protective and hindering psychological and clinical features associated with LTOT cessation success, and these can be found in earlier publications [14,30].
