Peggy Compton, PHD, RN, FAAN
In response to what the US Office of Drug Control Policy refers to as an “epidemic of prescription opioid abuse,” Peggy Compton explores the phenomena of opioid-induced hyperalgesia and addiction in patients on opioid therapy for the treatment of chronic pain. It is estimated that between 5 and 8 million Americans use prescription opioids on a daily basis for pain management, however this therapy is not an evidence-based intervention.
As evaluation data accumulates, it is becoming clear that outcomes are often poorer for patients on opioid therapy, and that a growing number of patients with chronic pain present with opioid use disorders. Her current work with chronic pain patients evaluates strategies to successfully taper them off opioids, determine if such tapers result in improved pain perception, and evaluate the role of responsible opioid prescribing to minimize untoward outcomes in this population.
“Substance abuse is a chronic disease and major source of morbidity and mortality in the US; it is also an exemplar for independent nursing intervention. Understanding how it affects the human experience of pain is critical to treating the suffering associated with each.”
- post-doc, University of California Los Angeles, 1995
- PhD, New York University, 1993
- MS, Syracuse University, 1986
- BSN, University of Rochester, 1982
Dr. Compton has created the novel program of research examining the clinical intersection of pain, opioids and addiction, and is the first to demonstrate opioid-induced hyperalgesia in persons with opioid use disorder (OUD) and on medications to OUD therapy. She has also developed several screening tools to predict risk for opioid use disorder in patients with chronic pain and on opioid therapy. Her work examines effects of pre- and peri-operative opioid use on post-operative acute and persistent pain. Having been doing research in this space for 30+ years, Dr. Compton has had a front seat historical perspective of the development of the current opioid crisis.
As outlined in her presentation, Opioid Addiction through the Lens of Social Justice, at the 2018 American Academy of Nursing “Transforming Health, Driving Policy” Conference, Dr. Compton’s contribution to social justice is to remind policy makers that addiction is the most highly stigmatized chronic disease in the US, which is imbued with moral and criminal attributions. This stigmatization is reflected in how sufferers are treated in the health care system; how health professional students are educated about the disease; how sufferers are able to access treatment; how non-evidence-based treatment options profit; and how addiction services are reimbursed.
Dr. Compton comes to Penn Nursing’s Psychiatric Mental Health NP program with undergraduate and graduate level teaching experience on courses concerned with physiology, pathophysiology, pharmacology, and neuropsychiatric nursing and is a frequent guest lecturer to a wide range of audiences on pain, neurophysiology, opiate pharmacology, and addiction.
Motivated by a fundamental desire to understand how the abuse of opioids in the context of addiction affects the functioning of human pain systems, Dr. Compton’s work is grounded in her neuropsychiatric nursing practice in addiction and pain treatment settings, and involves the testing and refinement of a novel nursing theory that pain and opiate addiction are interrelated phenomena co-expressed in unique human life responses. Dr. Compton has established herself as an expert in identifying opiate abuse and addiction in chronic pain patients, and has made significant contributions to the fields of addiction and pain.
Her experience working in several public treatment settings, coupled with her extensive research and publication on pain and opioids, has helped to establish methods to identify substance use disorders and addiction in chronic pain patients on ongoing analgesic therapy. Determining whether patients are taking their opioid medications appropriately, and aggressively treating addiction should it present, are critical to effective pain care, but often challenging for the primary care clinician. She has been instrumental in developing tools that utilize foundational assessment categories such as family/personal history of addiction, psychiatric disorders, and opioid use patterns, to assess substance use disorders .
Opportunities to Learn and Collaborate at Penn Nursing
As a mentor for nursing and non-nursing students in the areas of opioid use disorders and chronic pain, Dr. Compton also provides pre- and post-doctoral training opportunities for students interested in studying pain, opioids and addiction. Her role as teacher, researcher, and mentor is strengthened by interdisciplinary research collaborations with the NIDA Center for Studies of Addiction at the Perelman School of Medicine, the Penn Pain Medicine Center in the Department of Anesthesiology at the University of Pennsylvania Health Systems, and the University of Pennsylvania NIH Center of Excellence in Pain Education (COEPE).
Selected Career Highlights
- The Caron Treatment Center’s 2016 Metro DC Community Service Research Award
- Research in Addictions Nursing Annual Award, International Nurses Society on Addictions
- Expert Panel member, “Chasing the Dragon: The Life of an Opiate Addict,” documentary screening with Attorney General Loretta Lynch, FBI Director James Comey, and DEA Acting Administrator Chuck Rosenberg, Washington, D.C.
Cheatle MD, Compton P, Dhingra L, Wasser T, O’Brien C. (2019). Development of the Revised Opioid Risk Tool to Predict Opioid Use Disorder in Patients with Chronic Non-Malignant Pain. J Pain, Jan 25. pii: S1526-5900(18)30622-9. doi: 10.1016/j.jpain.2019.01.011.
Myers J, Compton P. (2017). Addressing the Potential for Perioperative Relapse in Those Recovering from Opioid Use Disorder. Pain Med, 0: 1–8. doi: 10.1093/pm/pnx277
Compton P, Canamar, C, Hillhouse, M, Ling, W. (2012). Hyperalgesia in heroin dependent patients and the effects of opioid substitution therapy. J Pain, 13: 401-409.
Compton P, Kehoe P, Sinha K, Torrington MA, Ling W. (2010). Gabapentin improves cold-pressor pain responses in methadone-maintained patients. Drug Alcohol Depend, 1;109(1-3):213-9.
Compton P, Wu SM, Schieffer B, Pham Q, Naliboff BD. (2008). Introduction of Self-report Version of the Prescription Drug Use Questionnaire and Relationship to Medication Agreement Non-compliance, J Pain Symptom Manage, 36(4):383-95.
Compton P, Geschwind DH, Alarcón M. (2003). Association Between Human mu-Opioid Receptor Gene Polymorphism, Pain Tolerance and Opioid Addiction, Am J Med Genet, 121B:76-82.
Compton P, Miotto K, Elashoff D. (2003). Precipitated Opioid Withdrawal Across Acute Physical Dependence Induction Methods, Pharm Biochem Behav, 77: 263-268.
Compton P, Charuvastra VC, Ling W. (2001). Pain Intolerance in Opioid-Maintained Former Opiate Addicts: Effect of Long-Acting Maintenance Agent, Drug Alcohol Depend, 63:139-146.
Compton P, Darakjian J, Miotto K. (1998). Screening for Addiction in Patients with Chronic Pain with “Problematic“ Substance Use: Evaluation of a Pilot Assessment Tool, J Pain Symptom Manage, 16:355-363.
Compton M. (1994). Cold Pressor Pain Tolerance in Opiate and Cocaine Abusers: Correlates of Drug Type and Use Status, J Pain Symptom Manage, 9:462-473.