Chronic pain patients on buprenorphine who struggle with physical discomfort used more cannabis and alcohol
Among people with chronic pain receiving buprenorphine for opioid use disorder, those with lower tolerance for physical discomfort used cannabis and alcohol more frequently.
Quick Facts
What This Study Found
In 163 chronic pain patients on buprenorphine for OUD, higher discomfort intolerance (difficulty tolerating uncomfortable physical sensations) was associated with more frequent cannabis use (IRR 1.11) and alcohol use (IRR 1.14). Discomfort avoidance (behavioral tendency to avoid discomfort) showed no such association.
Key Numbers
163 participants; mean age 45; 86% White; 41% used cannabis in past 30 days; 24% used alcohol; discomfort intolerance associated with cannabis use (IRR 1.11, p = .016) and alcohol use (IRR 1.14, p = .022)
How They Did This
Cross-sectional analysis of baseline data from the TOPPS intervention trial, using negative-binomial regression models adjusted for demographics, pain interference, depression, anxiety, and cigarette use among 163 chronic pain patients on buprenorphine.
Why This Research Matters
Understanding why people in OUD treatment use other substances can inform strategies to improve treatment retention and address the intersection of chronic pain and substance use.
The Bigger Picture
Substance use during OUD treatment is common and associated with lower retention. This finding suggests that difficulty tolerating physical discomfort, rather than avoidance behavior, drives some patients toward cannabis and alcohol as supplemental pain management.
What This Study Doesn't Tell Us
Cross-sectional design cannot determine causality; predominantly White sample limits generalizability; self-reported substance use; baseline data only without longitudinal follow-up
Questions This Raises
- ?Would improving discomfort tolerance skills reduce cannabis and alcohol use in this population?
- ?Does cannabis use help or hinder OUD treatment outcomes for chronic pain patients?
Trust & Context
- Key Stat:
- 41% of buprenorphine patients used cannabis in past 30 days
- Evidence Grade:
- Cross-sectional analysis of baseline trial data with appropriate statistical adjustment but no longitudinal component.
- Study Age:
- 2024 study
- Original Title:
- Associations of discomfort intolerance, discomfort avoidance, and cannabis and alcohol use among persons with chronic pain receiving prescription buprenorphine for opioid use disorder.
- Published In:
- Drug and alcohol dependence, 265, 112472 (2024)
- Authors:
- Haley, Danielle F(6), Stein, Michael D(2), Bendiks, Sally, Karzhevsky, Skylar, Pierce, Claire, Dunn, Ana, Herman, Debra S, Anderson, Bradley, Weisberg, Risa B
- Database ID:
- RTHC-05363
Evidence Hierarchy
Watches what happens naturally without intervening.
What do these levels mean? →Frequently Asked Questions
Why might chronic pain patients on buprenorphine use cannabis?
This study found that the key factor was discomfort intolerance, meaning difficulty tolerating uncomfortable physical sensations. Patients who struggled more with physical discomfort used cannabis (and alcohol) more frequently, suggesting they may be supplementing their pain management.
How common was cannabis use among these patients?
41% of participants reported using cannabis in the past 30 days. Alcohol use was also notable at 24%. These rates highlight how common other substance use is among people being treated for opioid use disorder.
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Cite This Study
https://rethinkthc.com/research/RTHC-05363APA
Haley, Danielle F; Stein, Michael D; Bendiks, Sally; Karzhevsky, Skylar; Pierce, Claire; Dunn, Ana; Herman, Debra S; Anderson, Bradley; Weisberg, Risa B. (2024). Associations of discomfort intolerance, discomfort avoidance, and cannabis and alcohol use among persons with chronic pain receiving prescription buprenorphine for opioid use disorder.. Drug and alcohol dependence, 265, 112472. https://doi.org/10.1016/j.drugalcdep.2024.112472
MLA
Haley, Danielle F, et al. "Associations of discomfort intolerance, discomfort avoidance, and cannabis and alcohol use among persons with chronic pain receiving prescription buprenorphine for opioid use disorder.." Drug and alcohol dependence, 2024. https://doi.org/10.1016/j.drugalcdep.2024.112472
RethinkTHC
RethinkTHC Research Database. "Associations of discomfort intolerance, discomfort avoidance..." RTHC-05363. Retrieved from https://rethinkthc.com/research/haley-2024-associations-of-discomfort-intolerance
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.