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. 2021 Aug;37(3):588-595.
doi: 10.1002/smi.3020. Epub 2021 Jan 1.

Distress tolerance among emergency department patients in acute pain: Associations with substance use treatment

Maria L Pacella-LaBarbara  1 , Caroline Maltese  1 , Madelyn McConaghy  1 , James Porter  1 , Michael L Young  1 , Brian Suffoletto  2
Affiliations

Distress tolerance among emergency department patients in acute pain: Associations with substance use treatment

Maria L Pacella-LaBarbara et al. Stress Health. 2021 Aug.

Abstract

Managing acute pain in individuals with a history of substance use disorders (SUD) is complex. Distress tolerance (DT) (e.g., the ability to handle uncomfortable sensations) may serve as an ideal non-pharmacological intervention target in this population. Among 293 emergency department (ED) patients seeking treatment for pain (Mage = 41; 42% Female; 43% Black), we examined rates of SUD treatment and DT, whether an objective DT task is feasible to conduct in the ED, and relationships between DT and SUD. Patients completed a self-report DT survey, an objective DT task, and brief surveys of pain, drug use, current or past SUD treatment, and depression/anxiety. Average DT was 18.50 (SD = 9.4) out of 50; patients with past or current SUD treatment (n = 43; 14.7%) reported lower DT than patients with no SUD treatment history (n = 250; 85.3%). Controlling for demographics, depression/anxiety, and pain severity, lower subjective DT (adjusted odds ratio [aOR] = 1.05) and objective DT (aOR = 1.02) was associated a current or past history or SUD treatment. Assessing subjective and objective DT in ED patients with acute pain is feasible; interventions aimed at boosting DT may improve outcomes among patients with acute pain and SUD.

Keywords: acute pain; distress tolerance; substance use.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

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