Observational studyAddiction (Abingdon, England)2021
Craving mediates the association between momentary pain and illicit opioid use during treatment for opioid-use disorder: an ecological momentary assessment study.
Observational study in Addiction (Abingdon, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 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
15 citing papers in PubMed, 22 citations in OpenAlex.
- The relationship of pain intensity and opioid craving with delayed methadone dose: A preliminary study of individuals with opioid use disorder.British journal of clinical pharmacology · 2024Trial
- Integrating cognitive bias modification for pain and opioid cues into medication for opioid use disorder clinical care: Feasibility, acceptability, and preliminary results.Drug and alcohol dependence · 2023Trial
- Pain assessment tools in patients with substance use disorders: a systematic scoping review.Addiction science & clinical practice · 2026Article
- Craving for opioid and cannabis use among adults with chronic pain: Insights from a 30-day ecological momentary assessment study.Drug and alcohol dependence · 2025Article
- A longitudinal observational study with ecological momentary assessment and deep learning to predict non-prescribed opioid use, treatment retention, and medication nonadherence among persons receiving medication treatment for opioid use disorder.Journal of substance use and addiction treatment · 2025Observational
- 'I crave not to feel uncomfortable' - investigating craving for opioids and cannabis among individuals with chronic pain.Drugs (Abingdon, England) · 2025Article
- Zoom-Delivered Empowered Relief for Chronic Pain: Observational Longitudinal Pilot Study Exploring Feasibility and Pain-Related Outcomes in Patients on Long-Term Opioids.JMIR formative research · 2025Observational
- Affect-laden risk profiles derived from two days of EMA predict substance use and quality of life three- and six-months after SUD treatment.Journal of substance use and addiction treatment · 2025Article
- Study Protocol for Pain Self-Management and Patient-Oriented Buprenorphine Dosing for Pain and Retention in Office-Based Opioid Treatment: A Hybrid Type 1, 2 × 2 Factorial Randomized Controlled Trial.Substance use & addiction journal · 2025Article
- Contemporaneous Link Between Pain and Craving in Patients Recovering from Prescription Opioid Use Disorder During Residential Treatment.Substance use & misuse · 2025Article
- Pain in alcohol use disorder: Evaluating effects of childhood trauma, perceived stress, and psychological comorbidity.Alcohol (Fayetteville, N.Y.) · 2024Article
- Case report: Successful induction of buprenorphine in medically complex patients concurrently on opioids: a case series at a tertiary care center.Frontiers in pharmacology · 2024Article
- Time-varying effect modeling with intensive longitudinal data: Examining dynamic links among craving, affect, self-efficacy and substance use during addiction recovery.Addiction (Abingdon, England) · 2023Article
- Attentional biases and daily game craving dynamics: An ecological momentary assessment study.Journal of behavioral addictions · 2022Article
- The Feasibility and Utility of Harnessing Digital Health to Understand Clinical Trajectories in Medication Treatment for Opioid Use Disorder: D-TECT Study Design and Methodological Considerations.Frontiers in psychiatry · 2022Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
aimTo assess the role of momentary pain on opioid craving and illicit opioid use among individuals receiving opioid agonist treatment.
designObservational study using ecological momentary assessment.
settingThe National Institute of Drug Abuse Intramural Research Program in the United States.
participantsFifty-six adults who qualified for opioid agonist treatment. MEASUREMENTS: Participants completed randomly prompted assessments of pain severity, stress, negative mood, opioid craving and illicit opioid use for a mean of 66 days [standard deviation (SD) = 27]. Urine samples were collected two to three times/week throughout.
findingsAlmost 70% of participants reported moderate average pain severity in the past 24 hours at intake and 35% of participants reported chronic pain. There were no significant differences in percent of opioid-positive urine samples (P = 0.73) and average level of opioid craving during the study period (P = 0.91) among opioid agonist treatment only patients versus opioid agonist treatment patients with chronic pain. However, momentary pain severity significantly predicted concurrent opioid craving [B = 0.02, 95% confidence interval (CI) = 0.01, 0.04], over and above stress and negative mood. Momentary opioid craving, in turn, significantly predicted illicit opioid use that was assessed in the next moment [odds ratio (OR) = 1.72, 95% CI = 1.12, 2.64), while controlling for autocorrelation and the effects of pain, negative mood and stress. Momentary opioid craving significantly mediated the prospective association between momentary pain and illicit opioid use (95% CI = 0.003, 0.032). Exploratory analysis revealed that momentary pain severity also significantly moderated the momentary association between stress and opioid craving (B = 0.02, 95% CI = 0.00, 0.04), such that when momentary pain severity increased, the association between the two intensified.
conclusionsAmong people receiving opioid agonist treatment, momentary pain appears to be indirectly associated with illicit opioid use via momentary opioid craving.
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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.