ReviewAnnals of behavioral medicine : a publication of the Society of Behavioral Medicine2021
CANUE: A Theoretical Model of Pain as an Antecedent for Substance Use.
Review in Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
50 citing papers in PubMed, 69 citations in OpenAlex.
- Study Protocol for a Pain Self-Management Intervention to Reduce Pain and Improve MOUD Engagement in Primary Care: A Randomized Trial.Substance use & addiction journal · 2026Trial
- Acceptance versus distraction as coping strategies for acute pain and pain-induced alcohol urge and approach inclinations.Experimental and clinical psychopharmacology · 2025Trial
- Importance of pain perception after mucogingival surgery in multiple Miller class III/RT2 gingival recessions: A randomized clinical trial.Medicina oral, patologia oral y cirugia bucal · 2025Trial
- Examining changes in pain interference via pandemic-induced isolation among patients receiving medication for opioid use disorder: a secondary data analysis.BMC public health · 2024Trial
- Review
- Psychological, behavioral, cognitive and social factors associated with single vs dual alcohol and cannabis use in adolescents with chronic pain.Addictive behaviors · 2026Article
- Pain is associated with reduced adherence to safer injection practices among people who inject opioids.Harm reduction journal · 2026Article
- Characterizing Alcohol Use and Expectancies for Alcohol Analgesia Among Breast Cancer Survivors With Arthralgia.Psycho-oncology · 2026Article
- Article
- Clinical pain intensity is associated with greater cannabis demand among people who regularly use cannabis.Pain reports · 2026Article
- Article
- The Role of Sleep Impairment in Associations Between Pain and Nicotine/Tobacco Dependence in Wave 6 of the Population Assessment of Tobacco and Health (PATH) Study.Substance use & misuse · 2026Article
- A conceptual framework for the intersection of hyperalgesia and hyperkatifeia in alcohol addiction.Alcohol (Fayetteville, N.Y.) · 2025Review
- Comparison of Experimental Pain Modulation by Hypnosis, Virtual Reality and Virtual Reality Hypnosis in Healthy Individuals.European journal of pain (London, England) · 2025Article
- Pain and Cognitive Concerns Among Breast Cancer Survivors: The Mediating Role of Substance Use Coping.Cancer medicine · 2025Article
- Associations of physical pain, alcohol use, and related factors in the daily lives of patients with chronic low back pain.Alcohol (Fayetteville, N.Y.) · 2025Article
- Nicotine, tobacco smoking, and pain in orthopedic trauma settings: a conceptual framework for practice and research.Archives of orthopaedic and trauma surgery · 2025Review
- Clinical and psychosocial changes in adults with opioid use disorder and chronic pain using medical cannabis: a brief report.Journal of cannabis research · 2025Article
- Pain Severity and Experiences with Pain Management Predict Alcohol Use Among Men Who Have Sex with Men Living with HIV.AIDS and behavior · 2025Article
- The association between pain and negative alcohol-related consequences among college students engaged in binge drinking: The moderating role of reward and relief drinking motives.Addictive behaviors · 2025Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundPain and substance use are frequently comorbid and have been shown to exert bidirectional effects. Self-medication of pain and distress via substance use is common and can be understood via negative reinforcement, ultimately strengthening the pathway between pain to substance use over time. As such, a testable model of the potentially modifiable candidate mechanisms that underlie the pain to substance use pathway is needed. PURPOSE: This review proposes a testable model of pain as an antecedent to substance use to guide future research and inform clinical practice.
methodsAn integrative review of current evidence regarding pain, substance use, and associated risk factors (i.e., negative affect, pain-related attitudes, negative urgency, and substance use outcome expectancies) was conducted.
resultsThe Catastrophizing, Anxiety, Negative Urgency, and Expectancy (CANUE) model highlights modifiable risk factors for self-medicating pain with substance use, including increased negative affect and maladaptive pain-related attitudes (i.e., pain catastrophizing, pain anxiety, and fear of pain), negative urgency, and substance-related outcome expectancies for pain relief and enhanced pain coping.
conclusionsTargeted behavioral and psychological interventions that address these factors may facilitate more adaptive pain-coping responses, thereby reducing the impacts of pain on substance use. Systematic research is needed to evaluate the validity and clinical utility of this model.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.