渴望阿片类药物和大麻使用的成人慢性疼痛：从一个30天的生态瞬间评估研究的见解

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence Pub Date : 2025-08-17 DOI:10.1016/j.drugalcdep.2025.112843

Jennifer D. Ellis , Ashley E. Chipoletti , Siny Tsang , Courtney D. Nordeck , Erin M. Anderson Goodell , Chung Jung Mun , Marc O. Martel , Cecilia L. Bergeria , Kelly E. Dunn , Ryan Vandrey , Johannes Thrul , Patrick H. Finan

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引用次数: 0

摘要

渴求是一种令人厌恶的状态，也是发展为非药物药物使用的危险因素。对生态瞬时评估（EMA）数据进行二次分析的目的是：1)测试在阿片类药物和大麻共同使用的日子里，渴望是否会升高；2)在慢性疼痛患者中，检查疼痛、疼痛灾难化、影响和压力作为当前和下一刻渴望的危险因素。方法在线招募同时使用阿片类药物和大麻的慢性疼痛成人（N = 46），完成一项为期30天的EMA研究，包括每天四次瞬间调查，评估阿片类药物和大麻的渴望、使用、疼痛和疼痛灾难化、影响和压力。线性混合效应模型估计了疼痛、疼痛灾难化、情感和压力与渴望在同一场合和未来之间的联系。结果大多数参与者都经历过一些渴望，尽管在分析中约有三分之一的参与者报告说，在研究期间，他们很少或没有渴望。在共同使用阿片类药物和大麻的日子里，在更大的疼痛灾难的背景下，对阿片类药物和大麻的渴望更高；观察到疼痛强度、情绪和压力对阿片类药物和大麻渴望的影响较小。在调整后的分析中，疼痛灾难化预测了未来对阿片类药物的渴望，尽管影响很小。结论：研究结果强调，一部分患者没有经历过渴望，但那些经历过的患者往往在疼痛强度和灾难加剧的日子里经历渴望。未来的研究应探讨疼痛灾难化在慢性疼痛患者渴望中的作用。

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Craving for opioid and cannabis use among adults with chronic pain: Insights from a 30-day ecological momentary assessment study

Background

Craving is an aversive state and risk factor for progression to nonmedical substance use. The aims of this secondary analysis of Ecological Momentary Assessment (EMA) data were 1) to test whether craving was elevated on days of co-use of opioids and cannabis, and 2) to examine pain, pain catastrophizing, affect, and stress as risk factors for current and next-moment craving, among patients with chronic pain.

Methods

Adults with chronic pain (N = 46) who used both opioids and cannabis were recruited online and completed a 30-day EMA study, consisting of four momentary surveys per day that assessed opioids and cannabis craving, use, pain and pain catastrophizing, affect, and stress. Linear mixed effects models estimated associations between pain, pain catastrophizing, affect, and stress with craving, at the same occasion and prospectively.

Results

Most participants experienced some craving, though about a third of participants included in analyses reported minimal or no craving for the duration of the study. Craving for opioids and cannabis was higher on days of co-use and in the context of greater pain catastrophizing; smaller effects were observed correlating pain intensity, affect, and stress to opioid and cannabis craving. In adjusted analyses, pain catastrophizing prospectively predicted future opioid craving, albeit the effect was small.

Conclusions

The findings highlight that subset of patients do not report experiencing craving, but those who do tend to experience craving on days with heightened pain intensity and catastrophizing. Future research should investigate the role of pain catastrophizing in craving among patients with chronic pain.

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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.