Associations of discomfort intolerance, discomfort avoidance, and cannabis and alcohol use among persons with chronic pain receiving prescription buprenorphine for opioid use disorder

IF 3.9 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2024-10-24 DOI:10.1016/j.drugalcdep.2024.112472

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Abstract

Background

Chronic pain and non-prescribed substance use are associated with lower retention in opioid use disorder (OUD) treatment. We examined the associations of perceived capacity to tolerate uncomfortable physical sensations (discomfort intolerance and discomfort avoidance) and cannabis and alcohol use among persons with chronic pain receiving prescription buprenorphine for OUD.

Methods

This study utilizes baseline data from 163 persons with chronic pain receiving prescription buprenorphine for OUD enrolled in the Treating Opioid use, Persistent Pain, and Sadness (TOPPS) intervention trial. We used negative-binomial regression models, adjusted for age, education, gender, race/ethnicity, pain interference, depression, generalized anxiety disorder, and average cigarettes smoked/day to estimate the associations of discomfort tolerance and discomfort avoidance with frequency of cannabis and alcohol use.

Results

Participants (n=163) were on average 45 years old (standard deviation=10.6) and predominantly White (86 %, n=141). Forty-one percent (n=66) used cannabis and 24 % (n=30) used alcohol use in the past 30 days. In adjusted models, discomfort intolerance was positively associated with days of cannabis use (IRR = 1.11, p =.016) and days of alcohol use (IRR = 1.14, p =.022). Discomfort avoidance was not associated with cannabis or alcohol use.

Conclusion

Individuals with chronic pain receiving prescribed buprenorphine for treatment of OUD with lower tolerance for physical discomfort may augment pain management with cannabis and alcohol. Given the intersections between substance use and retention in care for OUD, future work should extend this preliminary work by exploring these relationships over time and in experimental settings.

Clinical Trial # NCT03698669

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接受处方丁丙诺啡治疗阿片类药物使用障碍的慢性疼痛患者的不适不耐受、不适回避与大麻和酒精使用的关联。

背景：慢性疼痛和非处方药物使用与阿片类药物使用障碍（OUD）治疗中的低保留率有关。我们研究了接受处方丁丙诺啡治疗的慢性疼痛患者对不舒服身体感觉的感知忍受能力（不适不耐和不适回避）与大麻和酒精使用的关联：本研究利用了 163 名接受处方丁丙诺啡治疗 OUD 的慢性疼痛患者的基线数据，这些患者参加了治疗阿片类药物使用、持续疼痛和悲伤（TOPPS）干预试验。我们使用负二叉回归模型，并对年龄、教育程度、性别、种族/民族、疼痛干扰、抑郁、广泛性焦虑症和平均吸烟/天数进行调整，以估计不适耐受和不适回避与大麻和酒精使用频率之间的关联：参与者（人数=163）平均年龄 45 岁（标准差=10.6），主要为白人（86%，人数=141）。在过去 30 天内，41% 的参与者（人数=66）吸食大麻，24% 的参与者（人数=30）酗酒。在调整模型中，不耐受不适感与吸食大麻天数（IRR = 1.11，p =.016）和酗酒天数（IRR = 1.14，p =.022）呈正相关。避免不适与大麻或酒精的使用无关：结论：接受丁丙诺啡处方治疗 OUD 的慢性疼痛患者对身体不适的耐受性较低，可能会使用大麻和酒精来增强疼痛控制。鉴于药物使用与 OUD 患者的保留率之间存在交叉关系，未来的工作应通过在实验环境中长期探索这些关系来扩展这项初步工作。临床试验 # NCT03698669。

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来源期刊

Drug and alcohol dependence 医学-精神病学

CiteScore

7.40

自引率

7.10%

发文量

409

审稿时长

41 days

期刊介绍： Drug and Alcohol Dependence is an international journal devoted to publishing original research, scholarly reviews, commentaries, and policy analyses in the area of drug, alcohol and tobacco use and dependence. Articles range from studies of the chemistry of substances of abuse, their actions at molecular and cellular sites, in vitro and in vivo investigations of their biochemical, pharmacological and behavioural actions, laboratory-based and clinical research in humans, substance abuse treatment and prevention research, and studies employing methods from epidemiology, sociology, and economics.