De Aquino Joao P, Costa Gabriel P A, Nunes Julio C, Hudak Justin, Odette Madeleine, Garland Eric L
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; VA Connecticut Healthcare System (VACHS), West Haven, CT, United States; Clinical Neuroscience Research Unit (CNRU), Connecticut Mental Health Center (CMHC), New Haven, CT, United States.
Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States.
Drug Alcohol Depend. 2025 Aug 5;275:112812. doi: 10.1016/j.drugalcdep.2025.112812.
With evolving legislation and attitudes towards cannabis in the United States, individuals receiving long-term opioid therapy (LTOT) for chronic pain increasingly use cannabis intending to relieve pain and reduce opioid consumption. Although they might also use cannabis to compensate for emotion dysregulation, the role of emotion regulation capacity in this population's patterns of cannabis use has not been investigated. This study examined whether deficits in emotion regulation capacity, an endophenotype assessed via psychophysiological measures, are associated with more frequent cannabis use among individuals receiving LTOT for chronic pain.
We analyzed data from 104 participants (mean age=51.12 years; 68.35 % female; 88.46 % White) receiving LTOT for chronic pain. Cannabis use frequency was quantified by days of use over 90 days. Emotion regulation capacity was indexed using skin conductance response (SCR) and corrugator electromyography (fEMG) during passive viewing or cognitive reappraisal of negative stimuli. Pain severity was assessed using the Brief Pain Inventory.
Smaller reductions in SCR (β=-0.018, p < 0.001) and corrugator fEMG (β=-9.59, p < 0.001) difference scores, signifying weaker emotion regulation capacity, were associated with more days of cannabis use. Pain severity was not significantly associated with cannabis use frequency (β=0.026, p = 0.370).
These findings suggest that impaired emotion regulation capacity might be a more critical endophenotype associated with frequent cannabis use than pain severity and support the notion that cannabis use might primarily modulate affective processes in this population. These results highlight the potential for targeted emotion regulation interventions to address heavy cannabis use among pain patients receiving LTOT.
随着美国关于大麻的立法和态度不断演变，因慢性疼痛接受长期阿片类药物治疗（LTOT）的个体越来越多地使用大麻，以期缓解疼痛并减少阿片类药物的用量。尽管他们也可能使用大麻来代偿情绪失调，但情绪调节能力在该人群大麻使用模式中的作用尚未得到研究。本研究探讨了通过心理生理测量评估的内表型——情绪调节能力缺陷，是否与因慢性疼痛接受LTOT的个体更频繁使用大麻有关。
我们分析了104名因慢性疼痛接受LTOT的参与者（平均年龄=51.12岁；68.35%为女性；88.46%为白人）的数据。大麻使用频率通过90天内的使用天数来量化。在被动观看或对负面刺激进行认知重评期间，使用皮肤电导反应（SCR）和皱眉肌肌电图（fEMG）来衡量情绪调节能力。使用简明疼痛量表评估疼痛严重程度。
SCR（β=-0.018，p<0.001）和皱眉肌fEMG（β=-9.59，p<0.001）差异得分的降低幅度较小，表明情绪调节能力较弱，这与更多的大麻使用天数相关。疼痛严重程度与大麻使用频率无显著关联（β=0.026，p=0.370）。
这些发现表明，与疼痛严重程度相比，情绪调节能力受损可能是与频繁使用大麻相关的更关键的内表型，并支持大麻使用可能主要调节该人群情感过程的观点。这些结果凸显了针对性情绪调节干预措施对于解决接受LTOT的疼痛患者中大麻大量使用问题的潜力。
