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Observational Study
. 2022 Dec:143:108892.
doi: 10.1016/j.jsat.2022.108892. Epub 2022 Oct 1.

Longitudinal associations between pain and substance use disorder treatment outcomes

Erin Ferguson  1 , Ben Lewis  2 , Scott Teitelbaum  2 , Gary Reisfield  2 , Michael Robinson  1 , Jeff Boissoneault  3
Affiliations
Observational Study

Longitudinal associations between pain and substance use disorder treatment outcomes

Erin Ferguson et al. J Subst Abuse Treat. 2022 Dec.

Abstract

Introduction: Pain is commonly reported among those in treatment for substance use disorders (SUD) and is associated with poorer SUD treatment outcomes. The current study examined the trajectory of pain over the course of SUD treatment and associations with substance use outcomes.

Methods: This observational study included adults seeking treatment for alcohol, cannabis, or opioid use disorders (N = 811). Participants completed a battery of assessments at treatment admission, 30 days post admission, and at discharge, including measures of demographics, pain, quality of life, abstinence self-efficacy, and craving.

Results: Analyses indicated linear reductions in pain intensity and interference over time. Significant interactive effects were observed for opioid use disorder (OUD) and time, such that participants with OUD had greater reductions in pain intensity and interference over time compared to those without OUD. Elevated pain intensity was associated with negative treatment outcomes, including reduced quality of life and abstinence self-efficacy, and greater craving and negative affect.

Conclusions: Reductions in pain occur over the course of SUD treatment, particularly for those with OUD. Greater pain was also associated with adverse SUD treatment outcomes. Results suggest that treatment and associated abstinence may be beneficial for those with co-occurring pain and SUD, highlighting an additional benefit of improving access to SUD treatment for patients and health care systems. Future research should replicate these findings among diverse samples and further characterize the trajectory of pain during and after SUD treatment.

Keywords: Pain; Substance use; Substance use disorder; Treatment.

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Conflict of interest statement

Declaration of competing interest The authors declare no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
A linear decline in pain intensity over time was detected across the sample (b = −0.57, SE = 0.05; p < .001). However, individuals with OUD had greater pain intensity across all three time points (b = 0.47, SE = 0.12; p < .001), and experienced greater declines in pain over the course of treatment than those without OUD (b = −0.28, SE = 0.06; p < .001).
Fig. 2.
Fig. 2.
Like for pain intensity, pain interference declined over time across the sample (b = −0.86, SE = 0.07; p < .001). Individuals with OUD had greater pain interference across all three time points (b = 0.56, SE = 0.16; p < .001), and experienced greater declines in pain interference over the course of treatment than those without OUD (b = −0.31, SE = 0.08; p < .001).
See this image and copyright information in PMC

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