Pain Increases Risk of Relapse

Persistent pain is prevalent among people with substance use disorders.

It is not known, however, whether such pain increases the risk of relapse following periods of abstinence.

Researchers assessed data on pain and substance use in 397 adults who, as part of a larger trial, had been interviewed periodically in the 2 years after their discharge from an urban, residential alcohol and drug detoxification unit.

  • Sixteen percent of people reported persistent pain in the 2 years after detoxification.

People reporting persistent pain were significantly more likely than those with mild or no pain to have used the following in the past month at the 2 year follow-up:

  • heroin/opioids not prescribed for pain (5 times as likely than those without pain);
  • heavy amounts of alcohol (More than twice as likely as those without pain).

Comments: Persistent pain is common among alcohol and drug users who have undergone residential detoxification and increases the likelihood of relapse. This study suggests that people need to be aware and clinicians must be careful to screen for pain symptoms in patients with substance dependence.

When persistent pain is present, thoughtful management is required to minimize risks associated with undertreatment while not fostering opioid analgesic or alcohol abuse.

References: Larson MJ, Paasche-Orlow M, Cheng DM, et al. Persistent pain is associated with substance use after detoxification: a prospective cohort analysis. Addiction. 2007.


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