Childhood Trauma Linked to Cannabis Use and Greater Pain in People on Methadone | Research

The takeaway

Among people receiving methadone for opioid use disorder, childhood trauma correlated with more severe pain, higher alcohol use, and earlier cannabis initiation.

People interested in the intersection of trauma, pain, and substance use; addiction treatment professionals

r = -0.45 correlation between childhood trauma and earlier cannabis initiation

What the researchers found

Higher childhood trauma scores correlated with greater pain severity, increased alcohol consumption, and earlier age of first cannabis use. Cannabis users in the sample reported significantly higher levels of emotional abuse, sexual abuse, and physical neglect compared to non-users.

Why it matters

Childhood trauma is common among people with substance use disorders, but its specific relationship to cannabis use and pain in this population has been underexplored.

The numbers in context

Childhood trauma correlated with pain severity (r = 0.27, P = 0.03), alcohol use (r = 0.25, P = 0.04), and earlier cannabis initiation (r = -0.45, P < 0.001). Emotional abuse showed the strongest correlations with pain severity (r = 0.33) and interference (r = 0.28).

How the study worked

Cross-sectional study of 82 individuals receiving methadone for opioid use disorder. Researchers used validated questionnaires for childhood trauma (CTQ), pain (BPI), and substance use (TLFB) over the past 28 days.

What this study cannot tell us

Small sample size (82 participants). Cross-sectional design cannot establish whether trauma causes cannabis use or pain. Single-site study.

How to read the evidence

Small cross-sectional study at a single site; correlational design cannot establish causation.

When this study was published

2025 study using current clinical data

The bigger picture

This study adds to growing evidence that trauma histories shape substance use patterns. The finding that cannabis use, but not heroin or cocaine use, was linked to specific trauma subtypes suggests these relationships are more nuanced than a simple "trauma leads to drug use" narrative.

Questions still open

Does treating childhood trauma in OUD patients reduce their cannabis use or pain? Are people with trauma histories using cannabis specifically for pain relief?

Common questions

Does childhood trauma cause people to use cannabis?

This study found a correlation, not causation. People with higher trauma scores were more likely to use cannabis and started younger, but the study design cannot prove trauma directly caused cannabis use.

Why was cannabis use linked to trauma but heroin use was not?

The researchers did not find significant correlations between childhood trauma and heroin, tobacco, cocaine, or stimulant use in this sample. The specific link to cannabis and alcohol may reflect different motivations or pathways.

Read the original research

The Role of Childhood Trauma in Chronic Pain and Substance Use Among Individuals Receiving Methadone Treatment for Opioid Use Disorder.

Journal of addiction medicine

View on PubMed ↗Publisher’s paper ↗

Citation

Costa, Gabriel P A; Ra, Jocelyn; Meyerovich, Julia; Pittman, Brian; C Nunes, Julio; De Aquino, Joao P. (2025). The Role of Childhood Trauma in Chronic Pain and Substance Use Among Individuals Receiving Methadone Treatment for Opioid Use Disorder.. Journal of addiction medicine. https://doi.org/10.1097/ADM.0000000000001553