Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, 67 President Street, Charleston, South Carolina, 29425 United States; University of Houston, Department of Psychology, 126 Heyne, Houston, Texas, 77204 United States.
University of Houston, Department of Psychology, 126 Heyne, Houston, Texas, 77204 United States.
Drug Alcohol Depend. 2019 Nov 1;204:107456. doi: 10.1016/j.drugalcdep.2019.02.036. Epub 2019 Aug 22.
Chronic pain is a public health problem associated with opioid misuse. Yet, it is important to understand factors underlying opioid misuse in the context of pain. Alcohol use is one factor to consider given past work documenting use of alcohol to manage pain. However, it is unknown whether alcohol use severity exacerbates the relation between pain and opioid misuse. This study sought to examine relations between pain and prescription opioid misuse and the moderating role of alcohol use severity in two online survey studies of individuals with chronic pain.
Individuals with chronic pain (study 1, n = 364; study 2, n = 437) were administered measures of pain, alcohol use, and opioid misuse.
In study 1, there was a significant interaction of pain severity and alcohol use (b = 0.16, p < 0.001). Pain was significantly related to opioid misuse among those with higher (b = 1.50, p < 0.001), but not lower (b=-0.26, p = 0.430) alcohol use. In study 2, there was a significant interaction of pain severity and alcohol use (b = 0.03, p < 0.001). Pain was significantly related to opioid misuse among those with higher (b = 0.74, p < 0.001), but not lower (b = 0.07, p = 0.620) alcohol use.
In two online samples, there was evidence of a novel interaction of pain severity and alcohol use severity in relation to opioid misuse. Although cross-sectional, results replicated in two studies. Pain severity was related to opioid misuse among those with higher but not lower alcohol use. Those who use alcohol, even below suggested cut-offs, may be more likely to misuse opioids when in pain.
慢性疼痛是与阿片类药物滥用相关的公共卫生问题。然而，了解疼痛背景下阿片类药物滥用的潜在因素很重要。鉴于过去有研究记录到使用酒精来控制疼痛，酒精使用是需要考虑的一个因素。但是，目前尚不清楚酒精使用严重程度是否会加剧疼痛与阿片类药物滥用之间的关系。本研究旨在通过两项慢性疼痛患者的在线调查研究，检验疼痛与处方阿片类药物滥用之间的关系，以及酒精使用严重程度的调节作用。
对慢性疼痛患者（研究 1，n=364；研究 2，n=437）进行疼痛、酒精使用和阿片类药物滥用的测量。
在研究 1 中，疼痛严重程度和酒精使用之间存在显著的交互作用（b=0.16，p<0.001）。在酒精使用较高（b=1.50，p<0.001）而非较低（b=-0.26，p=0.430）的人群中，疼痛与阿片类药物滥用显著相关。在研究 2 中，疼痛严重程度和酒精使用之间存在显著的交互作用（b=0.03，p<0.001）。在酒精使用较高（b=0.74，p<0.001）而非较低（b=0.07，p=0.620）的人群中，疼痛与阿片类药物滥用显著相关。
在两项在线样本中，疼痛严重程度和酒精使用严重程度与阿片类药物滥用之间存在一种新的交互作用。尽管这是一项横断面研究，但结果在两项研究中得到了复制。在酒精使用较高的人群中，疼痛与阿片类药物滥用相关，但在酒精使用较低的人群中则不相关。那些使用酒精的人，即使低于建议的阈值，在疼痛时也更有可能滥用阿片类药物。
