Ripon Rezaul Karim, Maleki Nasim
Harvard T H Chan School of Public Health, Boston, USA.
Departement of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Suite 162, Building 62, 13th Street, Charlestown, MA, 02129, USA.
Sci Rep. 2025 Jul 1;15(1):22038. doi: 10.1038/s41598-025-04888-3.
Chronic pain is a significant global health problem that affects millions of people globally and in the US which can sometimes lead to unhealthy coping mechanisms such as substance use. This case-control study aimed to examine the relationship between chronic pain and substance use using data from the National Health and Nutrition Examination Study (NHANES). Descriptive analysis and logistic regression models were used to compare the odds of substance use in individuals according to a history of ongoing (≥ 6 weeks) or chronic pain (≥ 3 months). A total of 980 individuals were included in the analysis. Among them, 87.4% reported no substance use, 10.2% single substance use, and 2.3% polysubstance use. Compared with 19.33% of non-substance users, 23.36% of single substance users and 39.21% of polysubstance users reported current ongoing pain (p-value: 0.04). Examining the association between substance use and chronic pain revealed that polysubstance users had a significantly higher risk of having current or a history of ongoing pain or a history of chronic pain compared to non-users, with adjusted odds ratios (aORs) ranging from 2.28 (95% CI 2.27-2.29) to 6.30 (95% CI 6.28-6.32). Single substance users also faced increased risk, with aORs from 1.19 (95% CI 1.18-1.20) to 2.14 (95% CI 2.13-2.15). These results highlight the elevated risk of substance use associated with chronic pain, particularly elevated risk of polysubstance use, after adjustments for demographic, socioeconomic, and mental health factors. These findings emphasize the need for targeted interventions addressing chronic pain to potentially mitigate substance use risks.
慢性疼痛是一个重大的全球健康问题，影响着全球及美国数以百万计的人，有时会导致诸如药物使用等不健康的应对机制。这项病例对照研究旨在利用国家健康与营养检查调查（NHANES）的数据，研究慢性疼痛与药物使用之间的关系。描述性分析和逻辑回归模型被用于根据持续（≥6周）或慢性疼痛（≥3个月）病史，比较个体使用药物的几率。共有980人纳入分析。其中，87.4%报告未使用药物，10.2%报告单一药物使用，2.3%报告多物质使用。与19.33%的非药物使用者相比，23.36%的单一药物使用者和39.21%的多物质使用者报告当前存在持续疼痛（p值：0.04）。研究药物使用与慢性疼痛之间的关联发现，与非使用者相比，多物质使用者当前或有持续疼痛病史或慢性疼痛病史的风险显著更高，调整后的优势比（aORs）范围为2.28（95%置信区间2.27 - 2.29）至6.30（95%置信区间6.28 - 6.32）。单一药物使用者也面临更高风险，aORs为1.19（95%置信区间1.18 - 1.20）至2.14（95%置信区间2.13 - 2.15）。这些结果凸显了在调整人口统计学、社会经济和心理健康因素后，与慢性疼痛相关的药物使用风险升高，尤其是多物质使用风险升高。这些发现强调了需要针对慢性疼痛进行有针对性的干预，以潜在地降低药物使用风险。
