British Journal of Pain最新文献

{"title":"The association between chronic pain and deficits in attention: Is it mediated by disturbed sleep?","authors":"Giulia Zerbini, Cindy Strömel-Scheder, Anna Karmann, Philip Lang, Miriam Kunz, Stefan Lautenbacher","doi":"10.1177/20494637251342005","DOIUrl":"10.1177/20494637251342005","url":null,"abstract":"<p><strong>Objective: </strong>Persons with chronic pain suffer from additional symptoms and deficits that are directly or indirectly related to their condition. Attentional deficits are a common problem in these individuals. The same is true for sleep disturbances. It is well-known that night sleep affects attention the next day. Therefore, sleep disturbances might be responsible for the association between chronic pain and deficits in attention.</p><p><strong>Methods: </strong>We studied the gaze behaviour (absolute and relative fixation times, i.e., attentional biases) in patients with chronic musculoskeletal pain (<i>N</i> = 20) and pain-free individuals (<i>N</i> = 28). For that purpose, we used an eye-tracker to monitor gaze behaviour during the presentation of affective stimuli, that is, pictures of faces displaying joy, anger, pain, and neutral expressions. In addition, we assessed subjective/wellbeing parameters, as well as objective sleep parameters with a portable polysomnography (PSG) device during two nights at home, with the aim of testing the mediating role of sleep for the relationship between chronic pain and alterations of attention.</p><p><strong>Results: </strong>Patients with chronic pain exhibited overall shorter fixation times (on average ∼160 ms shorter fixation times). With respect to the attentional biases, all participants looked longer at the affective faces compared to the neutral ones, independent of group or type of affective stimulus. Several subjective sleep/wellbeing parameters, together with two PSG parameters (sleep efficiency and duration of awakenings), were significantly worse in patients with chronic pain. Despite this, only subjective sleep quality and sleep efficiency mediated the association of chronic pain and attentional processes.</p><p><strong>Conclusions: </strong>Our findings confirm previous studies showing attentional deficits and sleep disturbances in patients with chronic pain. However, our results only partially support the hypothesis that the relationship between chronic pain and altered attentional processes is due to disturbed sleep. Other mechanisms might be involved, highlighting the need for further studies.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637251342005"},"PeriodicalIF":1.3,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain modulation in amputees: Exploring conditioned pain modulation and its influencing factors on amputated and non-amputated sides: A cross-sectional study.","authors":"Sara Barbosa Franco, Silvia Di-Bonaventura, Kevin Pacheco-Barrios, Andre Sugugawara, Marta Imamura, Leandro Heidy Yoshioka, Linamara Battistella, Felipe Fregni","doi":"10.1177/20494637251336359","DOIUrl":"https://doi.org/10.1177/20494637251336359","url":null,"abstract":"<p><strong>Background: </strong>Amputation leads to significant physical, psychological, and emotional challenges, with chronic pain being among the most debilitating outcomes. Conditioned Pain Modulation (CPM) is a key mechanism for understanding pain modulation reflecting the central nervous system's capacity to regulate pain.</p><p><strong>Objective: </strong>This study aimed to evaluate CPM in amputees, comparing CPM between the amputated and non-amputated sides, and to identify factors influencing CPM in this population.</p><p><strong>Method: </strong>Eighty-six amputees participated in the study. Sociodemographic and pain-related variables, including age, occupation, smoking status, pre-amputation pain duration, phantom limb pain, and pressure pain threshold, were assessed. Multiple linear regression models were performed to explore factors associated with CPM on both sides, with additional <i>t</i>-tests to compare CPM values between sides.</p><p><strong>Results: </strong>The multivariate model for the amputated side explained 26.3% of CPM variability, with significant associations found for pre-amputation pain duration and retirement status, as well as PPT mean of the amputated side, smoking, and phantom limb pain and age. In contrast, the non-amputated side model explained 26.5% (Adjusted R-squared) of the variability, with the following significant variables: duration of pre-amputation pain (negative correlation), smoking history, phantom limb pain (negative correlation), and frequency of telescoping sensation (negative correlation). There were no significant differences in CPM between amputated and non-amputated sides (<i>p</i> > 0.05).</p><p><strong>Conclusion: </strong>The findings suggest that CPM on the amputated side is more influenced by pain experience and sociodemographic variables, while the non-amputated side shows less variability and is more resilient to these influences.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637251336359"},"PeriodicalIF":1.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring take-home opioid stewardship (ETHOS) in UK postoperative patients.","authors":"Zoe K Reed, Samantha Lai Sheung Ma, Hanin Ramadan, Edward Wd Flewitt, Nicole Hasler, Amy Hussey, Antony Palmer, Jane Quinlan","doi":"10.1177/20494637251336640","DOIUrl":"https://doi.org/10.1177/20494637251336640","url":null,"abstract":"<p><strong>Background: </strong>Surgery is one of the most common indications for a patient's first opioid prescription, with some patients progressing to unintended long-term use. There is no current data from the United Kingdom on how much patients use of the opioid medication dispensed at discharge from hospital. This study investigates discharge opioid prescribing and usage following common surgical procedures.</p><p><strong>Methods: </strong>This cohort study was conducted at the Oxford University Hospitals NHS Foundation Trust and involved 20 of the most commonly performed adult surgical procedures. At least 20 patients per procedure were surveyed using a standardised telephone questionnaire 6-8 days after discharge to establish the amount of used and unused opioids. Opioid doses were converted to oral morphine equivalent (OME) for analysis.</p><p><strong>Results: </strong>The amount of opioid given to patients after all types of surgery far exceeded requirement, with often large variations in prescribing practices for the same procedures, most notably in trauma and orthopaedics.For the cohort of 426 patients, a total of 55 080 mg OME was dispensed on discharge, with only 34.4% actually used by patients, leaving a total of 36 108.5 mg OME unused in the community, risking inappropriate opioid use, overdose, or diversion.</p><p><strong>Conclusions: </strong>Opioid overprescribing is common after surgery and represents waste, expense, and risk to patients. There is a clear need to develop a procedure-specific evidence-base for discharge opioid prescribing, adopting an \"enough but not too much\" approach to ensure that patients have adequate analgesia to facilitate functional surgical recovery, but not more than is needed.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637251336640"},"PeriodicalIF":1.3,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lived experience perspectives of persons with complex regional pain syndrome: a survey study of the history of their condition, treatments and functional outcomes.","authors":"Alexander Cd Smith, Benjamin H Miranda","doi":"10.1177/20494637251336636","DOIUrl":"https://doi.org/10.1177/20494637251336636","url":null,"abstract":"<p><strong>Background: </strong>Complex Regional Pain Syndrome (CRPS) is a rare, chronic pain disorder that can have a devastating impact. Its cause remains unclear and debate over treatment strategies continues. The aim of the study was to utilise patient-reported outcomes to aid in the further evaluation of treatment options.</p><p><strong>Method: </strong>An online survey was distributed with ethical approval to members of a CRPS charity. The Checklist for Reporting Results of Internet E-Surveys was implemented. Adults who met the patient-reported aspect of the Budapest Criteria were included (non-validated). Functional scores were reported using the shortened Disabilities of the Arm, Shoulder and Hand outcome measurement tool (QuickDASH) and Lower Extremity Functional Scale (LEFS). Participants completed a pre-injury score, a score related to injury and a score related specifically to CRPS symptoms. Respondents were also asked to rate a number of pharmacological and non-pharmacological treatments for CRPS.</p><p><strong>Results: </strong>Respondents were mostly female (87%, 447/514) with a mean age of 49 years (SD 13). 69% (354/514) reported trauma as the inciting event. Anxiety (55%, 283/514) was the most commonly reported co-morbidity. Opioids (72%, 258/358) and Physical Therapy/Rehabilitation (63%, 281/444) were reported as the most beneficial (used by >10% of respondents) pharmacological and non-pharmacological therapies respectively. Median CRPS functional scores were significantly worse than scores relating to the injury alone, for both QuickDASH (56 (IQR 36-77) versus 77 (IQR 61-91), <i>p</i> < .001) and LEFS (20 (IQR 8-40) versus 7 (IQR 3-17), <i>p</i> < .001).</p><p><strong>Conclusion: </strong>We present the first study using validated patient-reported outcome measures of limb-specific function in a solely CRPS population. These data quantify the devastating impact of CRPS and help make its prevention and treatment a priority amongst those who encounter it. The treatment data should inform future research, especially in successful therapies that were less commonly utilised.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637251336636"},"PeriodicalIF":1.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wrist and ankle acupuncture relief moderate to severe postoperative pain after functional endoscopic sinus surgery: A randomized controlled study.","authors":"Suying Guo, Yaqin Wang, Jianwei Ai, Jingyi Zhao, Shaoting Huang, Junge Wang","doi":"10.1177/20494637241264941","DOIUrl":"10.1177/20494637241264941","url":null,"abstract":"<p><strong>Introduction: </strong>The study aimed to validate the effectiveness of Wrist and Ankle Acupuncture (WAA) in attenuating moderate to severe postoperative pain following Functional Endoscopic Sinus Surgery (FESS).</p><p><strong>Methods: </strong>Participants were randomly allocated into a treatment group (<i>n</i> = 57) and a control group (<i>n</i> = 58). The treatment group underwent WAA treatment, while the control group received sham acupuncture treatment. The Numeric Rating Scale (NRS) was employed to assess postoperative pain. The sleep efficiency, the amount of rescue medication, and the adverse events were also evaluated for both groups.</p><p><strong>Results: </strong>A significant immediate reduction in NRS scores was observed in the treatment group (<i>p</i> < .01). At 2, 4, 8, 22, and 24 h after first treatment, pain intensity decreased in the WAA group compared with the control group (<i>p</i> < .01). Moreover, the WAA group demonstrated superior sleep efficiency relative to the control group on the night after surgery (<i>p</i> < .01). And the mean number of rescue tablets used on the WAA group was obviously lower than the control group (<i>p</i> < .01). There were no serious adverse events in both groups, and all adverse events completely disappeared within 3 days.</p><p><strong>Conclusion: </strong>WAA effectively alleviated postoperative discomfort associated with nasal packing subsequent to FESS and enhanced sleep quality during the postoperative night. The anatomical superficiality of the acupuncture points employed reduces the risk of adverse events while yielding effective analgesic results, thus validating its suitability for clinical application.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":"19 2","pages":"115-124"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No association exists between the use of implantable systems and longer survival in advanced cancer patients.","authors":"Sebastiano Mercadante","doi":"10.1177/20494637241264010","DOIUrl":"10.1177/20494637241264010","url":null,"abstract":"","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":"19 2","pages":"138-139"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of prehabilitation on outcomes following elective lumbar spine surgery: A systematic review and meta-analysis.","authors":"Lisandra Almeida de Oliveira, Julian Anthony Vitale, Jasmeet Singh Sachdeva, Srikesh Rudrapatna, Sava Ivosevic, Najih Nuradin Ismail, Anthony Cubello, Y V Raghava Neelapala, Nora Bakaa, Diego Roger-Silva, Luciana Macedo","doi":"10.1177/20494637251323175","DOIUrl":"10.1177/20494637251323175","url":null,"abstract":"<p><strong>Background: </strong>Elective lumbar spine surgery is increasingly being implemented to treat patients with specific low back pain. However, approximately 30% of patients continue to have long-term pain and disability after surgery.</p><p><strong>Objective: </strong>The aim of this study was to systematically review the literature on the effectiveness of pre-surgical rehabilitation (prehab) alone or in combination with usual care versus usual care on patient-oriented outcomes and health-related costs following elective lumbar spine surgery.</p><p><strong>Data sources: </strong>Electronic databases from MEDLINE, CINAHL, EMBASE, and AMED were systematically searched from their inception to November 2022.</p><p><strong>Study selection: </strong>Randomized controlled trials that examined adult (age >18 years) prehab programs and evaluated one or more outcomes of interest were included in this review.</p><p><strong>Data extraction: </strong>In pairs, six reviewers independently conducted a risk-of-bias assessment and extracted outcome data from included studies, in accordance with the Template for Intervention Description and Replication (TIDieR). A meta-analysis was conducted when trials were homogeneous.</p><p><strong>Data synthesis: </strong>A total of eight trials (<i>n</i> = 739 participants), reported in 13 different manuscripts, were eligible for inclusion. Exercise prehab interventions are superior to usual care for disability at 3-month (MD: -2.56, 95% CI -4.98 to -0.15), back pain at 6-month (MD: -6.65, 95% CI -13.25 to -0.05), and health-related costs (MD: €2572.8, 95% CI: €1963.0 to €3182.5). CBT prehab interventions seem to be superior to usual care for back pain at 3-month (MD: -7.3, 95% CI: -14.5 to -0.05). Individual trials showed that education prehab interventions may be superior to usual for back pain at 1-month post-operative (MD: 12.3, 95% CI: 0.9 to 23.7).</p><p><strong>Limitations: </strong>Overall, the inclusion of heterogeneous trials (e.g., diagnosis, types of surgery, dosage, content, and duration of interventions) with small sample sizes leads to inconclusive and very low certainty of effect estimates.</p><p><strong>Conclusion: </strong>The present systematic review has brought to light the dearth of high-quality evidence in support of prehab interventions for patients undergoing lumbar spine surgery. Given the uncertainty surrounding the results obtained from low-quality randomized controlled trials, it is currently not feasible to provide recommendations for clinical practice.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637251323175"},"PeriodicalIF":1.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'I want to know that it's worth me attending': A qualitative analysis of consumers' decisions not to attend their chronic pain group education session.","authors":"Amelia K Searle, Cindy L Wall, Celia Tan, Peter Herriot","doi":"10.1177/20494637251322977","DOIUrl":"10.1177/20494637251322977","url":null,"abstract":"<p><p><b>Background:</b> Many pain clinics encourage/mandate attendance at introductory group pain education sessions. Despite high non-attendance rates, no studies have examined consumer-reported reasons for non-attendance. <b>Purpose:</b> The aim of this study was to better understand why consumers fail to attend their pain education session. <b>Research Design and Study Sample:</b> We attempted to contact all non-attendees of our South Australian tertiary pain unit's group pain education sessions from February-August 2020. Of the 23 we could reach, 10 completed semi-structured telephone interviews. <b>Data Analysis:</b> Audio-recordings were transcribed verbatim and subject to thematic content analysis. <b>Results:</b> 'Attendance barriers' themes highlighted the complex lives of non-attendees. Pain prevented them from leaving their house, deterred them from travel to, and sitting through, the entire session. Competing responsibilities including other medical appointments and comorbidities were commonly mentioned. Most explicitly stated their dislike for the group format. Other factors included fear of the unknown nature of the session, not wanting education, and wanting a doctor's appointment. Several participants expressed a distrust of medical professionals, and perceived the benefits of attending as not exceeding the perceived time, money and pain associated. <b>Conclusions:</b> Pain management may not be individuals' main priority and attendance may only occur when other personal issues are addressed. Significant non-attendance rates may be unavoidable. Providing additional session detail may reduce misconceptions and allay concerns. Educating referring GPs may assist consumers to make an informed decision regarding attending. Online sessions may address various barriers and prove a more cost-effective alternative.</p><p><strong>Perspective: </strong>This article examines consumers' reasons for non-attendance at pre-clinic group education programs. Findings could be used by Pain Units to shape patient and GP communications regarding such programs, as well as program content and format, to improve patient acceptance and program attendance, and potentially engagement with self-management.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637251322977"},"PeriodicalIF":1.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient experience of discharge opioid analgesia and care provision following spine surgery: A mixed methods study.","authors":"Megan L Allen, Adam Pastor, Kate Leslie, Brennan Fitzpatrick, Malcolm Hogg, Hui Lau, Jo-Anne Manski-Nankervis","doi":"10.1177/20494637251322168","DOIUrl":"10.1177/20494637251322168","url":null,"abstract":"<p><strong>Background: </strong>Perioperative opioid stewardship programs are increasingly being introduced to guide responsible use around the time of surgery to reduce opioid-related harm to patients. However, patient experiences of perioperative opioid stewardship programs are underexplored.</p><p><strong>Methods: </strong>We designed a mixed methods study to explore patients' experiences of perioperative opioid stewardship in the post-operative period following spine surgery. We performed evaluative action research, combining quality improvement and ethnographic methodologies. Our quantitative methods were retrospective medical record review and targeted survey research. Our qualitative methods were online focus groups. The quantitative data were analysed using descriptive statistics, chi-square, and rank sum testing. The focus group data underwent inductive thematic analysis.</p><p><strong>Results: </strong>Our spine surgery cohort for the four-month study period included 101 patients. The median total discharge opioid dispensed was 75 mg [interquartile range 75-150 mg], with 30% of patients prescribed modified release opioids on discharge. A subset of patients (<i>N</i> = 14) participated in the online focus groups. The key themes that emerged from these sessions were (1) Supportive care delivery and rescue mechanisms were universally important to patient participants, providing great reassurance during their recovery; (2) Participants commonly believed opioid analgesia had an important role in recovery following spine surgery. Some patients were keen to dispose of surplus opioids whilst others intended to retain them; (3) Opioid analgesia access was variable, but established community prescriber relationships were important for post-discharge opioid re-prescription, and (4) The key future improvement suggestions included routine post-discharge contact and enhanced communication options back to the hospital if needed.</p><p><strong>Discussion and conclusions: </strong>Our mixed methods approach provided rich insights into the pain and opioid analgesia experiences of patients following spine surgery. These insights are useful when seeking to optimise perioperative opioid stewardship programs including better meeting the needs of patient consumers. Limitations included potential response and selection bias for the online focus groups towards younger, higher socioeconomic status patients.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637251322168"},"PeriodicalIF":1.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychedelics and chronic pain: self-reported outcomes on changed substance use patterns and health following naturalistic psychedelic use.","authors":"Nicolas G Glynos, Anne Baker, Jacob S Aday, Daniel Kruger, Kevin F Boehnke, Stephanie Lake, Philippe Lucas","doi":"10.1177/20494637251319497","DOIUrl":"10.1177/20494637251319497","url":null,"abstract":"<p><p>Psychedelic substances have shown preliminary efficacy for several neuropsychiatric disorders and are currently being investigated for chronic pain conditions. However, few studies have investigated outcomes of naturalistic psychedelic use among individuals with chronic pain, and none have assessed psychedelic-related changes in substance use patterns in this population. In a cross-sectional survey of adults who reported using psychedelics to self-treat a chronic pain condition (<i>n</i> = 466; 46.1% women), we investigated changed substance use patterns and self-reported outcomes on physical and mental health following use of a psychedelic. Most (86.3%; <i>n</i> = 391/453) indicated that they ceased or decreased use of one or more non-psychedelic substances \"as a result of\" psychedelic use, and 21.2% (<i>n</i> = 83/391) indicated that the decrease in use persisted for more than 26 weeks after psychedelic use. Alcohol (71.1%; <i>n</i> = 226/318) and prescription opioids (64.1%; <i>n</i> = 100/156) had the highest proportions for ceased/decreased use. Illicit opioids (27.8%; <i>n</i> = 22/79) and cannabis (21.5%; <i>n</i> = 78/362) had the highest proportions for increased/initiated use. In multivariate regression modeling, having a motivation to reduce one's substance use was positively associated with ceasing/decreasing substance use (<i>p</i> < .001). Perceptions of health outcomes following psychedelic use were broadly positive, and psilocybin was reported to be the most effective substance for both physical and mental health symptoms. Although limited by a cross-sectional study design, findings from this large sample merit future investigation into the benefits and risks of naturalistic psychedelic use among individuals with chronic pain.</p>","PeriodicalId":46585,"journal":{"name":"British Journal of Pain","volume":" ","pages":"20494637251319497"},"PeriodicalIF":1.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}