The relationship of resilience with prescription opioid use and misuse among people with spinal cord injury.

Purpose/objective: Spinal cord injury presents major long-term challenges, including the need to manage chronic pain and avoid overuse or misuse of prescription medication. Our purpose was to identify the extent to which resilience, bouncing back quickly from major challenges, is associated with prescription opioid use and misuse, controlling for depression.

Research method/design: Follow-up data were collected from 918 individuals with spinal cord injury. Resilience was assessed using the Brief Resilience Scale, and depression was measured with the Patient Health Questionnaire.

Results: In total, 13.6% of participants reported low resilience (n = 123), 66.1% reported moderate (n = 598), and 20.3% reported high resilience (n = 184). Resilience was protective of monthly/occasional use and misuse of opioids but not overall opioid use or regular weekly/daily use. Pain intensity was most highly associated with weekly/daily use, yet minimally related to occasional/monthly use. Depression was associated with misuse, overall opioid use, and regular use.

Conclusions/implications: Resilience was related to a lower likelihood of use of prescription opioid medications in situations where pain intensity was strongly associated with usage (i.e., intermittent use and using opioids other than prescribed). Resilience is strongly associated with a diminished likelihood of opioid misuse. (PsycInfo Database Record (c) 2025 APA, all rights reserved).