Division of Alcohol, Drugs, and Addiction, McLean Hospital, Belmont, Massachusetts, USA.
Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
Subst Use Misuse. 2021;56(1):87-92. doi: 10.1080/10826084.2020.1840590. Epub 2020 Nov 2.
Both childhood abuse and chronic pain are common in people with substance use disorders (SUDs). Studies have found that exposure to childhood abuse is associated with chronic pain in adulthood; however, few studies have examined this association in people with SUDs. This study aimed to characterize the association between childhood abuse and chronic pain presence and severity in adults with SUDs. Data were obtained from 672 treatment-seeking participants with SUDs on an inpatient detoxification unit. Regression models evaluated whether childhood physical or sexual abuse was associated with the likelihood of chronic pain and severity of several pain-related characteristics: pain catastrophizing, pain severity, and pain interference. Childhood physical and sexual abuse were significantly associated with a greater likelihood of chronic pain in adulthood. In the adjusted analyses, childhood physical abuse was associated with worse pain severity, whereas childhood sexual abuse was associated with greater pain catastrophizing and worse pain interference. Childhood physical and sexual abuse were associated with a greater likelihood of chronic pain in adults with SUDs. Among those with chronic pain, exposure to childhood abuse was associated with a more severe symptom profile, characterized by greater pain severity, more catastrophic interpretations of pain, and more pain-related interference with daily life. People with SUDs and a history of childhood abuse may benefit from screening for pain and interventions to reduce pain catastrophizing. These findings highlight the importance of longitudinal research to understand mechanisms linking childhood abuse exposure to later pain and substance misuse.
儿童期虐待和慢性疼痛在物质使用障碍（SUD）患者中很常见。研究发现，儿童期暴露于虐待与成年期的慢性疼痛有关；然而，很少有研究在 SUD 患者中检查这种关联。本研究旨在描述 SUD 成人中儿童期虐待与慢性疼痛存在和严重程度之间的关联。数据来自于在住院戒毒单位接受治疗的 672 名 SUD 患者。回归模型评估了儿童期身体或性虐待是否与慢性疼痛的可能性以及几种与疼痛相关的特征（疼痛灾难化、疼痛严重程度和疼痛干扰）的严重程度相关。儿童期身体和性虐待与成年后患慢性疼痛的可能性显著相关。在调整后的分析中，儿童期身体虐待与更严重的疼痛严重程度相关，而儿童期性虐待与更大的疼痛灾难化和更严重的疼痛干扰相关。儿童期身体和性虐待与 SUD 成人中慢性疼痛的可能性增加有关。在患有慢性疼痛的患者中，暴露于儿童期虐待与更严重的症状特征相关，表现为更严重的疼痛严重程度、对疼痛更具灾难性的解释以及更多与日常生活相关的疼痛干扰。有 SUD 和儿童期虐待史的人可能受益于对疼痛的筛查和减少疼痛灾难化的干预。这些发现强调了纵向研究的重要性，以了解将儿童期虐待暴露与后来的疼痛和物质滥用联系起来的机制。
