Department of Psychology, University of Houston, Houston, Texas, USA.
Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Behav Med. 2021 Jul-Sep;47(4):335-343. doi: 10.1080/08964289.2020.1742642. Epub 2020 Jun 17.
Opioid misuse is a significant public health concern with substantial medical, social, and economic costs. Cross cutting the personal and societal effects of this current crisis, opioid misuse is associated with poorer physical and mental health outcomes that impair function across numerous life domains. Importantly, opioid misuse disproportionately affects persons with chronic pain and individuals who smoke tobacco. Despite the higher risk for smokers with chronic pain to engage in opioid misuse, little work has examined how opioid misuse may be related to mental health problems, including other substance use, among this vulnerable group. The current study examined opioid misuse as a predictor of substance use and mental health problems among 187 ( = 39.02, = 9.94, 74.9% female) daily cigarette smokers with chronic pain who currently use opioids. Results indicated that opioid misuse is associated with greater tobacco (13% of variance), alcohol (27% of variance), and cannabis (22% of variance) problems, as well as anxiety (26% of variance) and depressive symptoms (26% of variance). These results highlight the potential importance of opioid misuse in terms of concurrent substance and mental health problems among smokers with chronic pain. Future work is needed to explicate directionality and temporal ordering in the observed relations.
阿片类药物滥用是一个重大的公共卫生问题，会带来巨大的医疗、社会和经济成本。阿片类药物滥用不仅对个人和社会产生影响，还与较差的身心健康结果相关，会损害众多生活领域的功能。重要的是，阿片类药物滥用在慢性疼痛患者和吸烟人群中更为普遍。尽管慢性疼痛的吸烟者滥用阿片类药物的风险更高，但很少有研究探讨阿片类药物滥用如何与这一弱势群体的心理健康问题（包括其他物质使用）相关。本研究考察了在 187 名（=39.02，=9.94，74.9%为女性）正在使用阿片类药物的慢性疼痛的每日吸烟者中，阿片类药物滥用作为物质使用和心理健康问题的预测因素。结果表明，阿片类药物滥用与更多的烟草（13%的差异）、酒精（27%的差异）和大麻（22%的差异）问题以及焦虑（26%的差异）和抑郁症状（26%的差异）有关。这些结果突出了阿片类药物滥用在慢性疼痛吸烟者的并发物质和心理健康问题方面的潜在重要性。需要进一步的研究来阐明观察到的关系中的方向性和时间顺序。
