Abstract
Chronic pain is closely associated with psychological comorbidities, including anxiety and depression, as well as substance use disorders, particularly alcohol use disorder and opioid use disorder. Recent research highlights the bidirectional nature of these relationships, suggesting that each of these variables can contribute to the onset and exacerbation of the others. The present study aims to examine whether negative affective states associated with chronic pain are linked to risk-related patterns of opioid and/or alcohol consumption in individuals suffering from chronic pain. To this end, a comprehensive battery of standardized instruments was administered to assess subjective pain intensity, anxious-depressive symptomatology, and substance use risk patterns for opioids and alcohol. The findings reveal a strong positive correlation between subjective pain levels, anxious-depressive symptoms, and opioid risk-taking behaviors. Notably, individuals with elevated scores on measures of anxiety and depression reported higher levels of subjective pain and demonstrated greater risk-taking behavior related to opioid use, compared to those with lower symptomatology scores. In conclusion, this study underscores chronic pain as a significant risk factor for the development of anxious-depressive disorders and opioid misuse. These findings highlight the importance of integrating psychological and substance use assessments in the management of chronic pain to inform targeted interventions and preventative strategies.
Competing Interest Statement
LHC has a past collaboration with Grunenthal, participating as a speaker in the outreach program to chronic pain patients organised by the pharmacist's organization "Muy Ilustre Colegio de Farmaceuticos de Valencia" and Grunenthal. However, this relationship has no direct relevance to the content of this paper, and Grunenthal had no role in the study design, data collection, analysis, or manuscript preparation."
Funding Statement
This study was funded by Delegacion de Gobierno para el Plan Nacional sobre Drogas, Ministerio de Sanidad, Spain (refs. PND2019-I038 and PND2024-I035).
Author Declarations
I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
Ethics committee/IRB of Hospital General Universitario de Valencia gave ethical approval for this work.
I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.
Yes
I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).
Yes
I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.
Yes
Data Availability
All data produced in the present study are available upon reasonable request to the authors