The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA.
The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA; Department of Psychology, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX, 78249, USA.
Drug Alcohol Depend. 2020 Jan 1;206:107681. doi: 10.1016/j.drugalcdep.2019.107681. Epub 2019 Oct 28.
We explored pain, psychological flexibility, and continued substance use among 100 adults treated with methadone for opioid use disorder (OUD). All participants had co-occurring chronic pain.
Participants recruited from a community treatment center between 2009 and 2010 completed an interviewer-facilitated assessment. Chronic pain severity and interference, psychological flexibility (mindfulness, acceptance, values success), past 30-day substance use, and demographics were reported. We modeled a zero-inflated negative binomial regression to examine 1) the probability that an individual does not use illicit substances and 2) illicit substance use frequency among those expected to use. Pain severity and mindfulness were included as predictors in the logit (zero inflated) model. Pain interference, acceptance, and values success were included as predictors in the negative binomial (count) model. We controlled for age and gender in both models.
Participants were predominantly (84%) Hispanic, and 64% used an illicit substance least once in the past 30 days. Greater degree of mindfulness significantly predicted the probability that an individual does not continue to use illicit substances (OR = 1.59, p < 0.05). Lower degree of values success significantly predicted greater illicit substance use frequency among those likely to use (IRR = 0.72, p < 0.01). No other variables were associated with continued substance use.
Findings suggest psychological flexibility is associated with continued substance use in this predominantly Hispanic sample of adults treated for OUD with co-occurring chronic pain. Study findings may have implications for how to address the treatment needs of this complex population.
我们研究了 100 名接受美沙酮治疗阿片类药物使用障碍（OUD）的成年人的疼痛、心理灵活性和持续物质使用情况。所有参与者都伴有慢性疼痛。
2009 年至 2010 年期间，参与者从社区治疗中心招募，完成了一次访谈者协助的评估。报告了慢性疼痛严重程度和干扰、心理灵活性（正念、接受、价值观成功）、过去 30 天的物质使用情况和人口统计学特征。我们建立了零膨胀负二项回归模型，以检验 1）个体不使用非法物质的概率和 2）预期使用非法物质的个体的使用频率。疼痛严重程度和正念被纳入逻辑（零膨胀）模型的预测因子。疼痛干扰、接受和价值观成功被纳入负二项（计数）模型的预测因子。我们在两个模型中都控制了年龄和性别。
参与者主要是（84%）西班牙裔，64%的人在过去 30 天内至少使用过一次非法物质。更高程度的正念显著预测了个体不继续使用非法物质的概率（OR=1.59，p<0.05）。较低程度的价值观成功显著预测了预期使用的个体中非法物质使用频率更高（IRR=0.72，p<0.01）。没有其他变量与持续物质使用相关。
研究结果表明，在这个以西班牙裔为主的接受美沙酮治疗伴有慢性疼痛的 OUD 成年人样本中，心理灵活性与持续物质使用有关。研究结果可能对如何满足这一复杂人群的治疗需求具有重要意义。
