Chronic pain & mental health
Connecting recovery pathways.
For many Veterans, chronic pain does not exist on its own. It lives alongside PTSD, depression, anxiety, disrupted sleep, strained relationships, and the daily effort of trying to function while carrying all of it at once. Too often, these challenges are treated separately, even though they shape one another in ways that can delay effective care, complicate recovery, and leave Veterans feeling caught between systems that do not fully connect.
At the Centre, we have approached this differently. Chronic pain and mental health as a connected reality demands more coordinated, evidence-informed responses.
This approach has allowed us to build a clearer picture of what Veterans living with pain are facing, and inform how systems of care strive to serve them better. Through studies supported by the Chronic Pain Centre of Excellence for Canadian Veterans (CPCoE), we have examined the complex relationship between chronic pain and mental health from multiple angles. This includes a systematic review of ketamine as a potential treatment approach, research examining how chronic pain and mental health conditions co-occur in military and Veteran populations and what that means for policy and service planning, and qualitative work exploring the day-to-day realities of living with pain through the perspectives of Veterans, family members, and service providers.
Together, these projects extend from problem identification to delineation of clearer pathways for prevention, treatment, and support. Our research is informing how care can become more coordinated, more responsive, and better aligned with the real experiences of the people it is meant to serve.
Active projects.
Investigating Potential Experiences and Outcomes of Ketamine Treatment
Posttraumatic stress disorder (PTSD) affects many Canadian Armed Forces members and Veterans. While many treatments exist, there is a call to understand the role of ketamine as a possible innovative treatment option. To understand how Veteran populations may respond to Ketamine, this study examines Veterans treatment experiences at the Operational Stress Injury (OSI) Clinic in London, Ontario. Findings may help improve the understanding of ketamine as a PTSD treatment and support more personalized care for Veterans.
Understanding how Veterans respond to ketamine treatment may help improve PTSD care and guide more personalized treatment approaches.
Exploring Possibilities in Provincial Health Programs: Immersive Stepped Care to Transform Chronic Pain Management for Canadian Veterans
Community-based approaches to chronic pain care can tailor care to individual needs, such as at the ChangePain Clinic. Their approach to chronic pain care for Canadian Veterans combines virtual group visits, education, and in-person treatment from a multidisciplinary team. To understand how such approaches support or not the care experience, this study will evaluate the ChangePain Clinic Program over a 12-month period. By exploring the program's impact and barriers to treatment, findings may help improve chronic pain care for Veterans across Canada.
Evaluating this personalized, community-based approach to chronic pain care could help improve access, quality of life, and health outcomes for Canadian Veterans and their families.
More about this study →INSPIRE: Increasing Veterans' Pathways to Information, Resilience, and Empowerment (Chronic Pain)
Transitioning from military to civilian life can be challenging for Veterans, particularly those living with chronic pain. Pain can affect daily activities, mental health, and access to services, creating additional barriers during this period. This study will explore how chronic pain affects Veterans’ transition and changing needs. Using a resilience-based approach, researchers will identify factors that support well-being and areas where Veterans and their families need additional support. Findings may help improve services and support for Veterans during and after their transition to civilian life.
Understanding how chronic pain affects Veterans’ transition to civilian life may help identify their changing needs and improve supports for Veterans and their families.
Echoes of Service: Understanding Veteran Experiences to Advise Chronic Pain Policy in Canada
Chronic pain policy needs to address the real experiences of Veterans living with pain, ensuring that care is accessible and appropriate. To explore Canadian Armed Forces (CAF) Veterans’ experiences with chronic pain care, we will conduct virtual interviews and an online survey. In doing so, we will identify barriers and factors that make it easier to access and engage in care.
Exploring Veterans’ experiences with accessing chronic pain care may help identify barriers and improve support and treatment.
What we've published on this work.
- Collins, E., Liu, JJW., Bilodeau, M., Burhan, AM., Enns, MW., Lavoie, V., Ein, N., Nazarov, A., Auger, E., Balderson, K., Mota, N., Wanklyn, S., & Richardson, JD. · 2026Benzodiazepine prescribing in chronic military-related PTSD: real-world patterns and correlates in specialized careFrontiers in Psychiatry
- O'Donnell, ML., Arjmand, HA., Lumley, MA., Seal, K., Mani, R., Sterling, M., Reed, DE. II, Sbisa, A., Bair, MJ., Bown, S., Dupuis, G., Forbes, D., Maher, P., McFarlane, AC., Moseley, GL., Otis, J., Pedlar, D., Richardson, JD., Fredrickson, J., Maunder, L., Dick, D., Wilkinson, E., Bennett, L., Blank, J., & Varker, T. · 2026Systematic review and meta-analyses of nonpharmacological interventions for co-occurring chronic pain and posttraumatic stress disorderPAIN
- Liu, JJW., Ein, N., Gervasio, J., Baker, C., Plouffe, RA., Wanklyn, S., Burhan, AM., Lau, B., Abreu, E., Wasiuta, T., Nazarov, A., & Richardson, JD. [**Ketamine in the Effective Management of Chronic Pain, Depression, and Posttraumatic Stress Disorder for Veterans: A Meta-Analysis and Systematic Review**](https://doi.org/10.3389/fpsyt.2024.1338581). _Frontiers in Psychiatry_, _15_, 1338581 · 2024Ketamine in the Effective Management of Chronic Pain, Depression, and Posttraumatic Stress Disorder for Veterans: A Meta-Analysis and Systematic ReviewFrontiers in Psychiatry
- Liu, J.J.W., Nazarov, A., Ein, N., et al. · 2024Ketamine in the effective management of chronic pain, depression, and PTSD for VeteransFrontiers in Psychiatry
- Skorzewska, A., Younger, WA., Dempster, KS., Nazarov, A., & Richardson, JD · 2024Buprenorphine for the Treatment of Military-related PTSD With Treatment-resistant Depression and Unexpected Benefit for Chronic Pain: Case ReportMilitary Medicine