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.

Haley, Danielle F et al.·Drug and alcohol dependence·2024·Preliminary EvidenceObservational
RTHC-05363ObservationalPreliminary Evidence2024RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Observational
Evidence
Preliminary Evidence
Sample
N=163

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)
Database ID:
RTHC-05363

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

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.

Read More on RethinkTHC

Cite This Study

RTHC-05363·https://rethinkthc.com/research/RTHC-05363

APA

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.