Perceived Discrimination and Problematic Opioid Use Among Black Individuals with Chronic Musculoskeletal Pain

Overview

Journal Psychol Addict Behav

Publisher American Psychological Association

Specialties Psychiatry
Psychology

Date 2023 Dec 7

PMID 38059948

Authors

James D Doorley

Julia E Hooker

Ellie A Briskin

Jafar Bakhshaie

Ana-Maria Vranceanu

Affiliations

Soon will be listed here.

Abstract

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 ( = 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, ² = .30, (6, 394) = 28.66, < .001. Perceived discrimination specifically was associated with more problematic opioid use (β = .39, = .05, < .001) and explained unique variance in this outcome even after accounting for pain intensity (β = .06, SE = .04, = .20), distress tolerance (β = -.10, = .05, = .04), pain avoidance (β = .12, = .05, = .02), age (β = -.10, = .05, < .05), and employment status (β = .13, = .11, < .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. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

References

Green C, Baker T, Sato Y, Washington T, Smith E . Race and chronic pain: A comparative study of young black and white Americans presenting for management. J Pain. 2003; 4(4):176-83. DOI: 10.1016/s1526-5900(02)65013-8. View

Wicksell R, Renofalt J, Olsson G, Bond F, Melin L . Avoidance and cognitive fusion--central components in pain related disability? Development and preliminary validation of the Psychological Inflexibility in Pain Scale (PIPS). Eur J Pain. 2007; 12(4):491-500. DOI: 10.1016/j.ejpain.2007.08.003. View

Verner M, Sirois A, Coutu-Nadeau E, Fournier C, Carriere J, Martel M . The Association Between Perceived Injustice and Opioid Craving in Patients With Chronic Pain: The Mediating Role of Daily Pain Intensity, Negative Affect, and Catastrophizing. J Addict Med. 2022; 17(1):35-41. DOI: 10.1097/ADM.0000000000001022. View

Greenberg J, Penn T, Doorley J, Grunberg V, Duarte B, Fishbein N . Pain catastrophizing, pain anxiety, and substance use among Black individuals with chronic pain who use opioids. Psychol Addict Behav. 2022; 37(7):977-984. PMC: 10878305. DOI: 10.1037/adb0000881. View

Zale E, Ditre J . Pain-Related Fear, Disability, and the Fear-Avoidance Model of Chronic Pain. Curr Opin Psychol. 2015; 5:24-30. PMC: 4383173. DOI: 10.1016/j.copsyc.2015.03.014. View

Morales M, Yong R . Racial and Ethnic Disparities in the Treatment of Chronic Pain. Pain Med. 2020; 22(1):75-90. DOI: 10.1093/pm/pnaa427. View

Meints S, Cortes A, Morais C, Edwards R . Racial and ethnic differences in the experience and treatment of noncancer pain. Pain Manag. 2019; 9(3):317-334. PMC: 6587104. DOI: 10.2217/pmt-2018-0030. View

Terry E, Fullwood M, Booker S, Cardoso J, Sibille K, Glover T . Everyday Discrimination in Adults with Knee Pain: The Role of Perceived Stress and Pain Catastrophizing. J Pain Res. 2020; 13:883-895. PMC: 7200232. DOI: 10.2147/JPR.S235632. View

Garner L, Van Kirk N, Tifft E, Krompinger J, Mathes B, Fraire M . Validation of the distress tolerance scale-short form in obsessive compulsive disorder. J Clin Psychol. 2017; 74(6):916-925. DOI: 10.1002/jclp.22554. View

10.

Baker T, Green C . Intrarace differences among black and white americans presenting for chronic pain management: the influence of age, physical health, and psychosocial factors. Pain Med. 2005; 6(1):29-38. DOI: 10.1111/j.1526-4637.2005.05014.x. View

11.

Zegel M, Rogers A, Vujanovic A, Zvolensky M . Alcohol use problems and opioid misuse and dependence among adults with chronic pain: The role of distress tolerance. Psychol Addict Behav. 2020; 35(1):42-51. DOI: 10.1037/adb0000587. View

12.

Matthews T, Sembajwe G, von Kanel R, Li J . Associations of employment status with opioid misuse: Evidence from a nationally representative survey in the U.S. J Psychiatr Res. 2022; 151:30-33. DOI: 10.1016/j.jpsychires.2022.04.001. View

13.

Brodish A, Cogburn C, Fuller-Rowell T, Peck S, Malanchuk O, Eccles J . Perceived Racial Discrimination as a Predictor of Health Behaviors: the Moderating Role of Gender. Race Soc Probl. 2012; 3(3):160-169. PMC: 3403827. DOI: 10.1007/s12552-011-9050-6. View

14.

Edwards R . The association of perceived discrimination with low back pain. J Behav Med. 2008; 31(5):379-89. DOI: 10.1007/s10865-008-9160-9. View

15.

Brown P, Watts V, Hanna M, Rizk M, Tucker E, Saddlemire A . Two Epidemics and a Pandemic: The Collision of Prescription Drug Misuse and Racism during COVID-19. J Psychoactive Drugs. 2021; 53(5):413-421. DOI: 10.1080/02791072.2021.1992048. View

16.

Gossop M, Darke S, Griffiths P, Hando J, Powis B, Hall W . The Severity of Dependence Scale (SDS): psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users. Addiction. 1995; 90(5):607-14. DOI: 10.1046/j.1360-0443.1995.9056072.x. View

17.

Howell A, Leyro T, Hogan J, Buckner J, Zvolensky M . Anxiety sensitivity, distress tolerance, and discomfort intolerance in relation to coping and conformity motives for alcohol use and alcohol use problems among young adult drinkers. Addict Behav. 2010; 35(12):1144-7. PMC: 2942953. DOI: 10.1016/j.addbeh.2010.07.003. View

18.

Rogers A, Bakhshaie J, Lam H, Langdon K, Ditre J, Zvolensky M . Pain-related anxiety and opioid misuse in a racially/ethnically diverse young adult sample with moderate/severe pain. Cogn Behav Ther. 2018; 47(5):372-382. DOI: 10.1080/16506073.2018.1436085. View

19.

Buckner J, Keough M, Schmidt N . Problematic alcohol and cannabis use among young adults: the roles of depression and discomfort and distress tolerance. Addict Behav. 2007; 32(9):1957-63. PMC: 1986746. DOI: 10.1016/j.addbeh.2006.12.019. View

20.

Von Korff M, DeBar L, Krebs E, Kerns R, Deyo R, Keefe F . Graded chronic pain scale revised: mild, bothersome, and high-impact chronic pain. Pain. 2019; 161(3):651-661. PMC: 7097879. DOI: 10.1097/j.pain.0000000000001758. View