Chronic pain patients who use cannabis more frequently show weaker emotion regulation abilities

What the researchers found

Smaller reductions in skin conductance and corrugator muscle activity during emotion regulation tasks were associated with more days of cannabis use over 90 days. Pain severity was not significantly associated with cannabis use frequency.

Why it matters

Many chronic pain patients report using cannabis to manage pain, but this study suggests the primary driver may actually be emotional distress rather than physical pain. If true, this shifts the conversation about why pain patients use cannabis and what interventions might help.

The numbers in context

Weaker skin conductance reduction during emotion regulation: beta = -0.018, p < 0.001. Weaker corrugator EMG reduction: beta = -9.59, p < 0.001. Pain severity and cannabis use: beta = 0.026, p = 0.370 (not significant). Sample: 104 participants, mean age 51.12 years.

How the study worked

Researchers analyzed data from 104 participants (mean age 51, 68% female, 89% White) receiving long-term opioid therapy for chronic pain. Cannabis use was measured as days used over 90 days. Emotion regulation was assessed via psychophysiological measures during passive viewing vs. cognitive reappraisal of negative images.

What this study cannot tell us

Cross-sectional design means causality cannot be determined: it is unclear whether poor emotion regulation leads to more cannabis use or vice versa. The sample was 89% White and predominantly female, limiting generalizability. Self-reported cannabis use days may be imprecise.

How to read the evidence

Small cross-sectional study with 104 participants using objective psychophysiological measures, but cannot establish causality.

When this study was published

Published in 2025.

The bigger picture

The disconnect between pain severity and cannabis use frequency challenges the common assumption that pain patients use cannabis primarily for analgesia. If emotion regulation deficits are the stronger predictor, targeted psychological interventions like mindfulness-based approaches might reduce problematic cannabis use more effectively than simply addressing pain.

Questions still open

• Does cannabis use worsen emotion regulation capacity over time, or do people with pre-existing deficits gravitate toward cannabis? Would emotion regulation training reduce cannabis use in this population? Do these findings hold for chronic pain patients not on opioids?

Common questions

Read the original research

Cannabis use frequency is associated with emotion dysregulation among persons receiving long-term opioid therapy for chronic pain: A psychophysiological study.

Drug and alcohol dependence, 275, 112812

Citation

De Aquino, Joao P; Costa, Gabriel P A; Nunes, Julio C; Hudak, Justin; Odette, Madeleine; Garland, Eric L. (2025). Cannabis use frequency is associated with emotion dysregulation among persons receiving long-term opioid therapy for chronic pain: A psychophysiological study.. Drug and alcohol dependence, 275, 112812. https://doi.org/10.1016/j.drugalcdep.2025.112812

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