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REVIEW ARTICLE

Complementary and alternative medicine for chronic pain among individuals with high-risk opioid use: A scoping review

Dianah Hayati1,2,3* ,  Chanyoung Park4 ,  Yuejia Wang4 ,  Heather Wang4 ,  Simreen Guram4 ,  Jane Kim1 ,  Mohammadali Nikoo1 ,  Louise Penzenstadler5 ,  Gemy Kuriakose6,7 ,  Michael Krausz1,2
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1 Department of Psychiatry, Faculty of Medicine, University of British Columbia (UBC), Vancouver, British Columbia , Canada
2 Department of Psychiatry, Institute of Mental Health, University of British Columbia (UBC), Vancouver, British Columbia , Canada
3 Cumming School of Medicine, University of Calgary, Calgary, Alberta , Canada
4 Faculty of Science, University of British Columbia (UBC), Vancouver, British Columbia , Canada
5 Addiction Division, Department of Psychiatry, Geneva University Hospital (HUG), Geneva , Switzerland
6 Faculty of Medical Sciences, Private University in the Principality of Liechtenstein (UFL), Triesen, Principality of Liechtenstein , Germany
7 Clinic for General and Geriatric Psychiatry, Klinikum Oberberg, Gummersbach, North Rhine- Westphalia , Germany
JCBP, 026270036 https://doi.org/10.36922/JCBP026270036
Received: 30 June 2026 | Revised: 10 September 2026 | Accepted: 15 September 2026 | Published online: 13 October 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

The opioid overdose crisis continues, driven by synthetic opioids such as fentanyl and nitazines. Chronic pain is a major driver of opioid use, with many individuals turning to non-prescription opioids for untreated or undertreated pain. Complementary and alternative medicine (CAM) offers a potential non-pharmacologic approach, but its role among individuals with high-risk opioid use remains unclear. This scoping review aims to map the existing evidence on CAM for chronic pain in this population. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Searches were conducted in Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing and Allied Health Literature, Embase, and Google Scholar using keywords related to chronic pain, opioid use disorder, and CAM. Studies were screened using Covidence, and findings were synthesized descriptively. A total of 40 studies were included. Mindfulness- and meditation-based interventions were the most frequently reported modalities, followed by yoga, Tai Chi, and Qigong. CAM was associated with improvements in pain coping, emotional regulation, anxiety, depression, self-management, and quality of life, while evidence for reductions in opioid use, craving, and misuse was less consistent and strongest for mindfulness-based interventions (Mindfulness-Oriented Recovery Enhancement). Current evidence highlights the potential of utilizing CAM as an adjunct to opioid agonist therapy and overall addiction treatment, highlighting its potential to address the biopsychosocial dimensions of chronic pain and recovery that are often unmet by pharmacologic treatment alone. As chronic pain and opioid use disorder increasingly require integrated approaches to care, CAM may represent a possible adjunctive strategy within addiction-treatment settings, although specific clinical research is needed to inform implementation and clinical practice.

Keywords
Chronic pain
Opioid use disorder
Complementary and alternative medicine
Integrative medicine
Addiction treatment.
Funding
None.
Conflict of interest
The authors declare they have no competing interests.
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