Vest Bonnie M, Hoopsick Rachel A, Homish D Lynn, Homish Gregory G
Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA.
Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA; Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA.
Addict Behav. 2020 Sep;108:106443. doi: 10.1016/j.addbeh.2020.106443. Epub 2020 Apr 15.
Military populations have a higher prevalence of pain compared to their civilian counterparts and are also at increased risk for substance use. The link between clinically significant pain and substance use has been established, but it is unclear if lower levels of pain relate to risk. The goal of this inquiry was to determine if level of bodily pain was associated with increased risk of current substance use over time among a community sample of U.S. Army Reserve/National Guard (USAR/NG) soldiers.
Data were drawn from an ongoing study of USAR/NG soldiers. We used generalized estimating equations to examine the longitudinal impact of baseline bodily pain level (modeled in standard deviations from the mean pain score) on current drug use (illicit and non-medical use of prescription drugs [NMUPD]) among soldiers (n = 387) over two-years. Final models controlled for baseline post-traumatic stress disorder (PTSD), anxiety, and depression symptomatology, history of deployment (yes/no), years of military service, and substance use norms.
Bodily pain was longitudinally associated with increased odds of current NMUPD (AOR: 1.49, p < .05), but not with the current use of illicit drugs (AOR: 1.18, p > .05), controlling for symptoms of PTSD, anxiety, depression, deployment, years of service, and substance use norms.
Overall, our findings indicate that bodily pain is longitudinally associated with NMUPD among male soldiers, but not with illicit drugs. Significantly, our results stem from a non-clinical sample of soldiers with overall lower levels of pain. This indicates that pain may be important, even at lower levels, and underscores the importance of early non-pharmacologic interventions for pain.
与平民相比,军人中疼痛的患病率更高,物质使用风险也更高。临床上显著疼痛与物质使用之间的联系已经确立,但尚不清楚较低程度的疼痛是否与风险相关。本研究的目的是确定在美国陆军后备役/国民警卫队(USAR/NG)士兵的社区样本中,身体疼痛程度是否与当前物质使用风险随时间增加有关。
数据来自一项正在进行的USAR/NG士兵研究。我们使用广义估计方程来检验基线身体疼痛程度(以平均疼痛评分的标准差为模型)对两年内士兵(n = 387)当前药物使用(非法和非医疗使用处方药[NMUPD])的纵向影响。最终模型控制了基线创伤后应激障碍(PTSD)、焦虑和抑郁症状、部署历史(是/否)、服役年限以及物质使用规范。
在控制了PTSD、焦虑、抑郁、部署、服役年限和物质使用规范的症状后,身体疼痛与当前NMUPD的几率增加纵向相关(调整后比值比[AOR]:1.49,p <.05),但与当前非法药物使用无关(AOR:1.18,p >.05)。
总体而言,我们的研究结果表明,身体疼痛与男性士兵的NMUPD纵向相关,但与非法药物无关。重要的是,我们的结果来自疼痛总体水平较低的非临床士兵样本。这表明疼痛可能很重要,即使程度较低,并强调了早期非药物性疼痛干预的重要性。