Peggy Compton, PHD, RN, FAAN

van Ameringen Chair in Psychiatric and Mental Health Nursing

Professor of Nursing

In response to what the Centers for Disease Control and Prevention (CDC) has referred to as the “opioid epidemic,” Peggy Compton explores the clinical intersection among opioids, pain and addiction. She has broad expertise in the phenomenon of opioid­-induced hyperalgesia, identifying opioid use disorder (OUD) in patients on opioid therapy for the treatment of chronic pain, and the management of pain and withdrawal in hospitalized patients with OUD. She advocates for effective pain care as a humane approach to developing a therapeutic alliance with persons with OUD as a means to encourage improved health care outcomes and recovery.

Conceptualizing pain and pleasure on a continuum of human experience, both of which are mediated by opioid systems, it is increasingly understood the experience of pain can be affected by unhealthy opioid use and that opioids prescribed to treat ongoing pain can result in OUD in vulnerable individuals. Recent and current research activities examine the role of opioid taper on pain responses; the use of short-acting opioids to manage pain and withdrawal in hospitalized patients with OUD; the effect of pre-operative opioid taper on post-operative pain responses; and the role of acute pain on patient-directed discharges.

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.

Education

  • Post-doc, University of California Los Angeles, 1995
  • PhD, New York University, 1993
  • MS, Syracuse University, 1986
  • BSN, University of Rochester, 1982

Innovation

Dr. Compton has created a novel program of research examining the clinical intersection of pain, opioids and addiction, and was 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.

Social Justice

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. She has also actively contributed to faculty efforts to integrate social justice concepts into the required PhD-level courses.

Teaching

Dr. Compton brings to Penn Nursing extensive undergraduate and graduate level teaching experience on courses concerned with pathophysiology, pharmacology, and neuropsychiatric nursing and is a frequent guest lecturer to a wide range of audiences on pain, neurophysiology, opioid pharmacology, and addiction. She has co-developed two elective courses at Penn Nursing on pain, OUD and caring for the patient with OUD.

Research

Motivated by a fundamental desire to understand how the use 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 OUD are interrelated phenomena co-expressed in unique human life responses. Dr. Compton has established herself as an expert in identifying opioid abuse and addiction in patients with chronic pain, and considering hospitalization for medical morbidity as an opportunity to intervene with concurrent OUD.

Clinical Practice

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 OUD in chronic pain patients on ongoing analgesic therapy. 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 identify substance use disorders in patients with ongoing pain. She is also active in practice improvement efforts to improve the management of acute pain in person hospitalized with OUD.

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 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 Center for Addiction Medicine and Policy at the Hospital of the University of Pennsylvania.

Selected Career Highlights

  • Lindback Award for Distinguished Teaching, University of Pennsylvania, 2023

 

  • Fellow, International Academy of Addictions Nurses, 2022

 

  • Margo McCaffery Nurse Exemplar Award, American Society of Pain Management Nurses, 2020

 

  • Betty Ford Award, Association for Multidisciplinary Education and Research in Substance use and Addiction (AMERSA), 2020

 

  • International Nurse Researcher Hall of Fame, Sigma Theta Tau International, 2020

Accepting Mentees?

  • No

Accepting Fellows?

  • No

Selected Publications

  • Compton P, Wang S, Fakhar C, Secreto S, Halabicky Arnold O, Ford B, Hersh EV. (in press). Pre- and Postoperative Hyperalgesia in Dental Patients on Chronic Opioid Therapy: A Pilot Study. Anesthesia Progress.

  • Thakrar AP, Uritsky TJ, Christopher C, Winston A, Ronning K, Sigueza AL, Caputo A, McFadden R, Olenik JM, Perrone J, Delgado MK, Lowenstein M, Compton P. (online ahead of print). Safety and Preliminary Outcomes of Short-Acting Opioid Agonist Treatment (sOAT) for Hospitalized Patients with Opioid Use Disorder. Addiction Science & Clinical Practice. doi:10.1186/s13722-023-00368-z

  • French R, McFadden R, Stewart R, Christian H, Compton P. (online ahead of print). “I just need proper treatment:” Being Hospitalized for Endocarditis among Individuals Who Inject Drugs. Journal of General Internal Medicine. DOI: 10.1007/s11606-023-08133-3

  • Darlington CK, Compton PA, Teitelman AM, Alexander K. (Online ahead of print). Non-pharmacologic Interventions to Improve Depression and Anxiety among Pregnant and Parenting Women Who Use Substances: An Integrative Literature Review. Drug and Alcohol Dependence Reports.https://doi.org/10.1016/j.dadr.2021.100017

  • Edmond SN, Snow JL, Pomeranz J, Van Cleve R, Black AC, Compton P, Becker WC. (2023). Delphi Study to Explore a New Diagnosis for “Ineffective” Long-Term Opioid Therapy for Chronic Pain. PAIN164(4), 870-876. doi: 10.1097/j.pain.0000000000002783

  • Sowicz TJ, Compton P, Matteliano D, Oliver J, Strobbe S, St. Marie B, Turner HN, Wilson M (2023). Position statement: Pain management and substance use disorders. Journal of Addictions Nursing 34(1), 5-7. DOI: 10.1097/JAN.0000000000000506

  • Axson SA, Giordano NA, Compton P, McDonald CC, Pinto-Martin JA (2022). Characterizing opioid prescribing to adolescents at time of discharge from a pediatric hospital over a five-year period. Journal of Pediatric Nursing. 66, 104–110. https://doi.org/10.1016/j.pedn.2022.05.023

  • Compton P, Halabicky OM, Aryal S, Badiola I. (2022). Opioid Taper is Associated with Improved Experimental Pain Tolerance in Patients with Chronic Pain: An Observational Study. Pain Ther. https://doi.org/10.1007/s40122-021-00348-8

  • Turner HN, Oliver J, Compton P, Matteliano D, Sowicz TJ, Strobbe S, St Marie B, Wilson M. (2022). Pain Management and Risks Associated with Substance Use: Practice Recommendations. Pain management nursing : official journal of the American Society of Pain Management Nurses, 23(2), 91–108. https://doi.org/10.1016/j.pmn.2021.11.002

  • Compton P, St Marie B. (2022). Coexisting Substance Use Disorder and Chronic Pain During COVID-19. Pain management nursing : official journal of the American Society of Pain Management Nurses, 23(1), 17–25. https://doi.org/10.1016/j.pmn.2021.08.011

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