title: Days with pain and substance use disorders: is there an association?
abstract: OBJECTIVE
  We investigated possible associations between pain frequency and the 5 most common substance use disorders: alcohol abuse/dependence, cocaine abuse/dependence, methamphetamine abuse/dependence, opioid abuse/dependence, and marijuana abuse/dependence.
  
  
  METHODS
  We used data from the Rural Stimulant Study, a longitudinal (7 waves), observational study of at-risk stimulant users (cocaine and methamphetamine) in Arkansas and Kentucky (n=462). In fixed-effects logistic regression models, we regressed our measures of substance use disorders on the number of days with pain in the past 30 days and depression severity.
  
  
  RESULTS
  Time periods when individuals had 1 to 15 days [odds ratio (OR)=1.85, P<0.001] or 16+ days (OR=2.18, P<0.001) with pain in the past 30 days were more likely to have a diagnosis of alcohol abuse/dependence, compared with time periods when individuals had no days with pain. Compared with time periods when individuals had no pain days in the past 30 days, time periods when individuals had 16+ pain days were more likely to have a diagnosis of opioid abuse/dependence (OR=3.32, P=0.02). Number of days with pain was not significantly associated with other substance use disorders.
  
  
  CONCLUSIONS
  Pain frequency seems to be associated with an increased risk for alcohol abuse/dependence and opioid abuse/dependence in this population, and the magnitude of the association is medium to large. Further research is needed to investigate this in more representative populations and to determine causal relationships.
authors.affiliation: Behavioral Health Epidemiology, RTI International, Research Triangle Park, NC 27709-2194, USA.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Edlund
authors.forename: Mark D
authors.initials: MD
authors.lastname: Sullivan
authors.forename: Xiaotong
authors.initials: X
authors.lastname: Han
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Booth
mesh_terms: D000293:Adolescent; D000328:Adult; D001131:Arkansas / Q000453:epidemiology; D005260:Female; D006801:Humans; D007629:Kentucky / Q000453:epidemiology; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019370:Observation; D010146:Pain / Q000453:epidemiology*; D012307:Risk Factors; D012424:Rural Population; D019966:Substance-Related Disorders / Q000145:classification / Q000453:epidemiology* / Q000523:psychology*; D013997:Time Factors; D055815:Young Adult