Abstract
BackgroundChronic pain is a prevalent condition that causes functional impairment and emotional suffering. To allay pain-induced suffering, opioids are often prescribed for chronic pain management. Yet, chronic pain patients on opioid therapy are at heightened risk for opioid misuse—behaviors that can lead to addiction and overdose. Relatedly, chronic pain patients are at elevated risk for suicidal ideation and suicidal behaviors.Main bodyOpioid misuse and suicidality are maladaptive processes aimed at alleviating the negative emotional hyperreactivity, hedonic hyporeactivity, and emotion dysregulation experienced by chronic pain patients on opioid therapy. In this review, we explore the role of emotion dysregulation in chronic pain. We then describe why emotionally dysregulated chronic pain patients are vulnerable to opioid misuse and suicidality in response to these negative affective states.ConclusionEmotion dysregulation is an important and malleable treatment target with the potential to reduce or prevent opioid misuse and suicidality among opioid-treated chronic pain patients.
Highlights
Chronic pain is a prevalent condition that causes functional impairment and emotional suffering
Emotion dysregulation may result in multiple forms of maladaptive behavior, here we focus on opioid misuse and suicidality as sequelae of chronic pain due to their high prevalence and significant public health impact
We explore the role of emotion dysregulation as a transdiagnostic process underlying the development and maintenance of opioid misuse and suicidality in this high-risk population
Summary
Affective, and physiological antecedents and consequences of pain render chronic pain patients prescribed long-term opioid pharmacotherapy vulnerable to opioid misuse and suicidality—two hazardous behaviors with significant mortality risk. Established bidirectional relationships between pain, opioid use, and affective distress underscore the potential role of emotion dysregulation in the development and maintenance of opioid misuse and suicidality among chronic pain patients. Emotion dysregulation represents an important transdiagnostic treatment target for future prevention and intervention approaches designed to reduce lethal and life-threatening behaviors among opioid-treated chronic pain patients. MRR, SEP, MOH, and ELG drafted the manuscript. All authors read and approved the final manuscript. Author details 1University of Utah College of Social Work, 395 South 1500 East, Salt Lake City, UT 84112, USA. Author details 1University of Utah College of Social Work, 395 South 1500 East, Salt Lake City, UT 84112, USA. 2Center on Mindfulness and Integrative Health Intervention Development, 395 South 1500 East, Salt Lake City, UT 84112, USA. 3University of North Carolina at Chapel Hill, Tate Turner Kuralt Building, Chapel Hill, NC 25799, USA
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