Emotion dysregulation may explain why cannabis problems lead to worse mental health in chronic pain patients

Among 431 adults with chronic pain, cannabis use problems were linked to worse anxiety, depression, and suicidal ideation, with emotion dysregulation explaining much of these relationships.

Orr, Michael F et al.·Psychology·2020·Moderate EvidenceCross-Sectional
RTHC-02758Cross SectionalModerate Evidence2020RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=431

What This Study Found

In 431 opioid-using adults with moderate to severe chronic pain (176 current cannabis users, 30% with cannabis use problems), emotion dysregulation significantly mediated the relationship between cannabis use problems and anxiety, depression, and suicidal ideation. The indirect effects through emotion dysregulation were significant for all three outcomes.

Key Numbers

431 participants; 176 current cannabis users; 30.2% with cannabis use problems; significant indirect effects via emotion dysregulation for anxiety, depression, and suicidal ideation.

How They Did This

Cross-sectional mediation analysis in 431 opioid-using adults with chronic pain, testing whether emotion dysregulation explained relationships between cannabis use problems and anxiety, depression, and suicidal ideation.

Why This Research Matters

Many chronic pain patients use cannabis, but those who develop problematic use patterns may have worse mental health. Understanding that emotion dysregulation is the connecting mechanism suggests a treatment target.

The Bigger Picture

This suggests that treating emotion regulation skills in chronic pain patients who use cannabis could simultaneously improve mental health outcomes and reduce problematic cannabis use.

What This Study Doesn't Tell Us

Cross-sectional (cannot establish temporal order); opioid-using sample may not represent all chronic pain patients; self-report measures; mediational design assumes causal ordering that may be reversed.

Questions This Raises

  • ?Would emotion regulation therapy improve outcomes for chronic pain patients with cannabis use problems?
  • ?Does cannabis use cause emotion dysregulation or do those with pre-existing dysregulation develop cannabis problems?

Trust & Context

Key Stat:
Emotion dysregulation mediated cannabis-mental health link for all three outcomes
Evidence Grade:
Moderate: reasonable sample with mediation analysis, but cross-sectional and self-report.
Study Age:
Published 2020.
Original Title:
Is there a relationship between cannabis use problems, emotion dysregulation, and mental health problems among adults with chronic pain?
Published In:
Psychology, health & medicine, 25(6), 742-755 (2020)
Database ID:
RTHC-02758

Evidence Hierarchy

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

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Why do cannabis problems worsen mental health in chronic pain patients?

This study found emotion dysregulation, the inability to effectively manage negative emotions, explained much of the link between cannabis use problems and anxiety, depression, and suicidal ideation.

Does this mean cannabis is bad for chronic pain patients?

Not necessarily. Cannabis use itself was not the focus; rather, it was problematic cannabis use patterns. The findings suggest that difficulty regulating emotions, not cannabis per se, is the key factor linking problematic use to poor mental health.

Read More on RethinkTHC

Cite This Study

RTHC-02758·https://rethinkthc.com/research/RTHC-02758

APA

Orr, Michael F; Rogers, Andrew H; Shepherd, Justin M; Buckner, Julia D; Ditre, Joseph W; Bakhshaie, Jafar; Zvolensky, Michael J. (2020). Is there a relationship between cannabis use problems, emotion dysregulation, and mental health problems among adults with chronic pain?. Psychology, health & medicine, 25(6), 742-755. https://doi.org/10.1080/13548506.2019.1653485

MLA

Orr, Michael F, et al. "Is there a relationship between cannabis use problems, emotion dysregulation, and mental health problems among adults with chronic pain?." Psychology, 2020. https://doi.org/10.1080/13548506.2019.1653485

RethinkTHC

RethinkTHC Research Database. "Is there a relationship between cannabis use problems, emoti..." RTHC-02758. Retrieved from https://rethinkthc.com/research/orr-2020-is-there-a-relationship

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.