Association between chronic pain and substance use

Abstract

Chronic pain is a significant global health problem that affects millions of people globally and in the US which can sometimes lead to unhealthy coping mechanisms such as substance use. This case-control study aimed to examine the relationship between chronic pain and substance use using data from the National Health and Nutrition Examination Study (NHANES). Descriptive analysis and logistic regression models were used to compare the odds of substance use in individuals according to a history of ongoing (≥ 6 weeks) or chronic pain (≥ 3 months). A total of 980 individuals were included in the analysis. Among them, 87.4% reported no substance use, 10.2% single substance use, and 2.3% polysubstance use. Compared with 19.33% of non-substance users, 23.36% of single substance users and 39.21% of polysubstance users reported current ongoing pain (p-value: 0.04). Examining the association between substance use and chronic pain revealed that polysubstance users had a significantly higher risk of having current or a history of ongoing pain or a history of chronic pain compared to non-users, with adjusted odds ratios (aORs) ranging from 2.28 (95% CI 2.27-2.29) to 6.30 (95% CI 6.28-6.32). Single substance users also faced increased risk, with aORs from 1.19 (95% CI 1.18-1.20) to 2.14 (95% CI 2.13-2.15). These results highlight the elevated risk of substance use associated with chronic pain, particularly elevated risk of polysubstance use, after adjustments for demographic, socioeconomic, and mental health factors. These findings emphasize the need for targeted interventions addressing chronic pain to potentially mitigate substance use risks.

Keywords: Chronic pain; Depression; Depressive symptoms; Polysubstance; Substance use.