Rogers Andrew H, Heggeness Luke F, Smit Tanya, Zvolensky Michael J
Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, 77204, Houston, TX, USA.
Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, USA.
J Behav Med. 2023 Oct;46(5):860-870. doi: 10.1007/s10865-023-00416-8. Epub 2023 May 6.
Chronic low back pain (CLBP) is a significant public health problem that is associated with opioid misuse and use disorder. Despite limited evidence for the efficacy of opioids in the management of chronic pain, they continue to be prescribed and people with CLBP are at increased risk for misuse. Identifying individual difference factors involved in opioid misuse, such as pain intensity as well as reasons for using opioids (also known as motives), may provide pertinent clinical information to reduce opioid misuse among this vulnerable population. Therefore, the aims of the current study were to examine the relationships between opioid motives-to cope with pain-related distress and pain intensity, in terms of anxiety, depression, pain catastrophizing, pain-related anxiety, and opioid misuse among 300 (M= 45.69, SD = 11.17, 69% female) adults with CLBP currently using opioids. Results from the current study suggest that both pain intensity and motives to cope with pain-related distress with opioids were associated with all criterion variables, but the magnitude of variance explained by coping motives was larger than pain intensity in terms of opioid misuse. The present findings provide initial empirical evidence for the importance of motives to cope with pain-related distress with opioids and pain intensity in efforts to better understand opioid misuse and related clinical correlates among adults with CLBP.
慢性下腰痛（CLBP）是一个重大的公共卫生问题，与阿片类药物滥用及使用障碍相关。尽管阿片类药物在慢性疼痛管理中的疗效证据有限，但它们仍在被处方，且CLBP患者滥用风险增加。识别阿片类药物滥用中涉及的个体差异因素，如疼痛强度以及使用阿片类药物的原因（也称为动机），可能会提供相关临床信息，以减少这一脆弱人群中的阿片类药物滥用。因此，本研究的目的是在300名（平均年龄45.69岁，标准差11.17，69%为女性）目前正在使用阿片类药物的CLBP成年人中，研究阿片类药物动机（即应对与疼痛相关的痛苦）与疼痛强度之间的关系，涉及焦虑、抑郁、疼痛灾难化、与疼痛相关的焦虑以及阿片类药物滥用。本研究结果表明，疼痛强度和用阿片类药物应对与疼痛相关痛苦的动机均与所有标准变量相关，但就阿片类药物滥用而言，应对动机所解释的方差量大于疼痛强度。本研究结果为用阿片类药物应对与疼痛相关痛苦的动机和疼痛强度在更好地理解CLBP成年人阿片类药物滥用及相关临床关联方面的重要性提供了初步实证证据。
