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Craving mediates the association between momentary pain and illicit opioid use during treatment for opioid‐use disorder: an ecological momentary assessment study.

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Title: Craving mediates the association between momentary pain and illicit opioid use during treatment for opioid‐use disorder: an ecological momentary assessment study.
Authors: Mun, Chung Jung (AUTHOR), Finan, Patrick H. (AUTHOR), Epstein, David H. (AUTHOR), Kowalczyk, William J. (AUTHOR), Agage, Daniel (AUTHOR), Letzen, Janelle E. (AUTHOR), Phillips, Karran A. (AUTHOR), Preston, Kenzie L. (AUTHOR)
Source: Addiction. Jul2021, Vol. 116 Issue 7, p1794-1804. 11p. 1 Diagram, 5 Charts, 1 Graph.
Subjects: Chronic pain & psychology, Evaluation of drug utilization, Substance abuse risk factors, Chronic pain, Narcotics, Research, Substance abuse, Narcotic antagonists, Pain measurement, Scientific observation, Affect (Psychology), Confidence intervals, Desire, Drug use testing, Risk assessment, Descriptive statistics, Drugs of abuse, Urinalysis, Odds ratio, Psychological stress
Geographic Terms: United States
Abstract: Aim: To assess the role of momentary pain on opioid craving and illicit opioid use among individuals receiving opioid agonist treatment. Design Observational study using ecological momentary assessment. Setting: The National Institute of Drug Abuse Intramural Research Program in the United States. Participants: Fifty‐six adults who qualified for opioid agonist treatment. Measurements Participants completed randomly prompted assessments of pain severity, stress, negative mood, opioid craving and illicit opioid use for a mean of 66 days [standard deviation (SD) = 27]. Urine samples were collected two to three times/week throughout. Findings Almost 70% of participants reported moderate average pain severity in the past 24 hours at intake and 35% of participants reported chronic pain. There were no significant differences in percent of opioid‐positive urine samples (P = 0.73) and average level of opioid craving during the study period (P = 0.91) among opioid agonist treatment only patients versus opioid agonist treatment patients with chronic pain. However, momentary pain severity significantly predicted concurrent opioid craving [B = 0.02, 95% confidence interval (CI) = 0.01, 0.04], over and above stress and negative mood. Momentary opioid craving, in turn, significantly predicted illicit opioid use that was assessed in the next moment [odds ratio (OR) = 1.72, 95% CI = 1.12, 2.64), while controlling for autocorrelation and the effects of pain, negative mood and stress. Momentary opioid craving significantly mediated the prospective association between momentary pain and illicit opioid use (95% CI = 0.003, 0.032). Exploratory analysis revealed that momentary pain severity also significantly moderated the momentary association between stress and opioid craving (B = 0.02, 95% CI = 0.00, 0.04), such that when momentary pain severity increased, the association between the two intensified. Conclusions: Among people receiving opioid agonist treatment, momentary pain appears to be indirectly associated with illicit opioid use via momentary opioid craving. [ABSTRACT FROM AUTHOR]
Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Craving mediates the association between momentary pain and illicit opioid use during treatment for opioid‐use disorder: an ecological momentary assessment study.
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  Data: <searchLink fieldCode="AR" term="%22Mun%2C+Chung+Jung%22">Mun, Chung Jung</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Finan%2C+Patrick+H%2E%22">Finan, Patrick H.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Epstein%2C+David+H%2E%22">Epstein, David H.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kowalczyk%2C+William+J%2E%22">Kowalczyk, William J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Agage%2C+Daniel%22">Agage, Daniel</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Letzen%2C+Janelle+E%2E%22">Letzen, Janelle E.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Phillips%2C+Karran+A%2E%22">Phillips, Karran A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Preston%2C+Kenzie+L%2E%22">Preston, Kenzie L.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Addiction%22">Addiction</searchLink>. Jul2021, Vol. 116 Issue 7, p1794-1804. 11p. 1 Diagram, 5 Charts, 1 Graph.
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  Data: <searchLink fieldCode="DE" term="%22Chronic+pain+%26+psychology%22">Chronic pain & psychology</searchLink><br /><searchLink fieldCode="DE" term="%22Evaluation+of+drug+utilization%22">Evaluation of drug utilization</searchLink><br /><searchLink fieldCode="DE" term="%22Substance+abuse+risk+factors%22">Substance abuse risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Chronic+pain%22">Chronic pain</searchLink><br /><searchLink fieldCode="DE" term="%22Narcotics%22">Narcotics</searchLink><br /><searchLink fieldCode="DE" term="%22Research%22">Research</searchLink><br /><searchLink fieldCode="DE" term="%22Substance+abuse%22">Substance abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Narcotic+antagonists%22">Narcotic antagonists</searchLink><br /><searchLink fieldCode="DE" term="%22Pain+measurement%22">Pain measurement</searchLink><br /><searchLink fieldCode="DE" term="%22Scientific+observation%22">Scientific observation</searchLink><br /><searchLink fieldCode="DE" term="%22Affect+%28Psychology%29%22">Affect (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Desire%22">Desire</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+use+testing%22">Drug use testing</searchLink><br /><searchLink fieldCode="DE" term="%22Risk+assessment%22">Risk assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Drugs+of+abuse%22">Drugs of abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Urinalysis%22">Urinalysis</searchLink><br /><searchLink fieldCode="DE" term="%22Odds+ratio%22">Odds ratio</searchLink><br /><searchLink fieldCode="DE" term="%22Psychological+stress%22">Psychological stress</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22United+States%22">United States</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Aim: To assess the role of momentary pain on opioid craving and illicit opioid use among individuals receiving opioid agonist treatment. Design Observational study using ecological momentary assessment. Setting: The National Institute of Drug Abuse Intramural Research Program in the United States. Participants: Fifty‐six adults who qualified for opioid agonist treatment. Measurements Participants completed randomly prompted assessments of pain severity, stress, negative mood, opioid craving and illicit opioid use for a mean of 66 days [standard deviation (SD) = 27]. Urine samples were collected two to three times/week throughout. Findings Almost 70% of participants reported moderate average pain severity in the past 24 hours at intake and 35% of participants reported chronic pain. There were no significant differences in percent of opioid‐positive urine samples (P = 0.73) and average level of opioid craving during the study period (P = 0.91) among opioid agonist treatment only patients versus opioid agonist treatment patients with chronic pain. However, momentary pain severity significantly predicted concurrent opioid craving [B = 0.02, 95% confidence interval (CI) = 0.01, 0.04], over and above stress and negative mood. Momentary opioid craving, in turn, significantly predicted illicit opioid use that was assessed in the next moment [odds ratio (OR) = 1.72, 95% CI = 1.12, 2.64), while controlling for autocorrelation and the effects of pain, negative mood and stress. Momentary opioid craving significantly mediated the prospective association between momentary pain and illicit opioid use (95% CI = 0.003, 0.032). Exploratory analysis revealed that momentary pain severity also significantly moderated the momentary association between stress and opioid craving (B = 0.02, 95% CI = 0.00, 0.04), such that when momentary pain severity increased, the association between the two intensified. Conclusions: Among people receiving opioid agonist treatment, momentary pain appears to be indirectly associated with illicit opioid use via momentary opioid craving. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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    Identifiers:
      – Type: doi
        Value: 10.1111/add.15344
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        Text: English
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      – SubjectFull: Chronic pain & psychology
        Type: general
      – SubjectFull: Evaluation of drug utilization
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      – SubjectFull: Substance abuse risk factors
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      – SubjectFull: Chronic pain
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      – SubjectFull: Narcotics
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      – SubjectFull: Substance abuse
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      – SubjectFull: Narcotic antagonists
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      – SubjectFull: Pain measurement
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      – SubjectFull: Scientific observation
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      – SubjectFull: Affect (Psychology)
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      – SubjectFull: Confidence intervals
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      – SubjectFull: Desire
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      – SubjectFull: Drug use testing
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              Text: Jul2021
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