Pain catastrophizing, pain anxiety, and substance use among Black individuals with chronic pain who use opioids.

Greenberg, Jonathan; Penn, Terence; Doorley, James; Grunberg, Victoria A.; Duarte, Brooke A; Fishbein, Nathan S.; Bakhshaie, Jafar; Vranceanu, Ana‐Maria

doi:10.1037/adb0000881

Cited by 2 publications

(1 citation statement)

References 38 publications

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“…The fact that pain avoidance contributed to this association in our study is consistent with the cumulative stress and allostatic load models, in which mounting experiences of discrimination deplete coping resources, which may increase the risk of reliance on unhealthy/avoidant coping strategies (McClendon et al, 2021; Seeman et al, 1997). Another study using these data showed that other maladaptive psychological responses to pain (anxiety and catastrophizing) were associated with the risky use of various substances, including opioids (Greenberg et al, 2022). Additionally, given that Black individuals have lower rates of concurrent nonopioid treatment (e.g., physical therapy; Gebauer et al, 2017; Hausmann et al, 2013), they may have fewer opportunities to learn strategies for managing pain outside of medication use and avoidance behaviors.…”

Section: Discussionmentioning

confidence: 99%

Perceived discrimination and problematic opioid use among Black individuals with chronic musculoskeletal pain.

Doorley,

Hooker,

Briskin

et al. 2024

Psychology of Addictive Behaviors

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Objective: Chronic musculoskeletal pain (CMP) is prevalent, burdensome, and associated with an increased risk for opioid use disorder. Evidence suggests that perceived racial/ethnic discrimination is associated with problematic substance use among Black individuals, but studies have not focused on problematic opioid use among Black individuals with CMP specifically or explored the contribution of perceived discrimination, pain intensity, and pain-relevant psychological factors to this association. Method: We recruited 401 Black individuals (M age = 35.98, 51.9% female) with self-reported CMP and prescription opioid use. We tested whether perceived discrimination (a) was associated with self-reported problematic opioid use and (b) explained unique variance in this outcome after accounting for pain intensity, demographic factors, and psychological factors previously implicated in problematic opioid/substance use (distress tolerance and pain avoidance). Results: Hierarchical linear regression analysis revealed that our model as a whole explained significant variance in problematic opioid use, R 2 = .30, F(6, 394) = 28.66, p < .001. Perceived discrimination specifically was associated with more problematic opioid use (β = .39, SE = .05, p < .001) and explained unique variance in this outcome even after accounting for pain intensity (β = .06, SE = .04, p = .20), distress tolerance (β = −.10, SE = .05, p = .04), pain avoidance (β = .12, SE = .05, p = .02), age (β = −.10, SE = .05, p < .05), and employment status (β = .13, SE = .11, p < .01). Conclusions: Systemic efforts to combat racism along with individualized therapeutic approaches to process and cope with perceived racial discrimination may be particularly important to prevent and reduce problematic opioid use among Black individuals with CMP. Public Health Significance StatementThis study found that perceived discrimination was associated with self-reported problematic opioid use among Black individuals with CMP above and beyond pain intensity, distress tolerance, pain avoidance, age, and employment status. This suggests that perceived discrimination may be a particularly important intervention target for reducing the risk of problematic opioid use and opioid use disorder among Black individuals with chronic pain.

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