Pain Intensity and Hazardous Cannabis Use: The Moderating Role of Pain-related Anxiety.

Although cannabis has gained attention as a potential treatment for chronic pain, hazardous cannabis use (i.e. patterns of use that have harmful consequences) has been linked to negative health outcomes. Pain intensity is associated with greater cannabis use, and individuals with greater pain-related anxiety may be more likely to respond to pain with substance use. However, no prior work has examined the role of pain-related anxiety in hazardous cannabis use among individuals with chronic pain. The current analyses tested whether pain-related anxiety moderates associations between pain intensity and hazardous cannabis use. Participants included 80 cannabis users with chronic pain (63% male; 67% White;  = 33.6). Results indicated a positive interaction between pain intensity and pain-related anxiety on hazardous cannabis use ( < .05), such that pain intensity was positively associated with hazardous cannabis use among individuals with moderate and high pain-related anxiety, but not those with low pain-related anxiety, suggesting that pain-related anxiety may function as a transdiagnostic vulnerability factor for greater co-occurring pain and hazardous cannabis use. Future work should examine longitudinal associations between pain, pain-related anxiety, and hazardous cannabis use. There may be clinical utility in addressing pain-related anxiety among cannabis users with chronic pain.