ArticleAnnals of behavioral medicine : a publication of the Society of Behavioral Medicine2023
The Role of Environmental Context and Physical Activity in Prescribed Opioid Use and Pain in Daily Life among Patients With Chronic Low Back Pain.
Article in Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 7 citations in OpenAlex.
- 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
- Contextual and psychosocial factors influencing drug reward in humans: The importance of non-drug reinforcement.Pharmacology, biochemistry, and behavior · 2024Review
- Analysis of physical activity and prescription opioid use among US adults: a cross-sectional study.BMC public health · 2024Article
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundPrescription opioids remain a primary treatment option for patients with chronic low back pain. However, little research has examined how patients take opioids in daily life. Behavioral economics suggest that the environmental context may contribute to patients' decisions around opioid use. PURPOSE: This study examined the association of self-reported environmental factors and physical activity with likelihood of taking opioids, opioid dosage, and physical pain.
methodPatients with chronic low back pain on long-term opioid therapy (n = 34) without significant past-year opioid-related problems completed a two-week ecological momentary assessment protocol (nobservations = 1,714).
resultsInitial multilevel models revealed multiple associations for different specific contexts with opioid use and pain. In models that collapsed specific contexts into categories (where, with whom, doing what), greater occasion-level physical activity was associated with a greater likelihood of taking opioids and greater pain, and being somewhere (v. at home) was associated with taking a smaller opioid dose. At any given occasion, being with someone (v. alone) was associated with taking a larger opioid dose, but patients who spent more time with others over the entire study took fewer opioids overall. Multilevel mediation found that pain did not mediate the association of physical activity and opioid use.
conclusionResults suggest that prescribed opioid use in patients with chronic low back pain is not solely determined by pain, but influenced by environmental factors, including physical activity. Psychoeducation regarding environmental factors, including how factors may be associated with both increased and decreased use of opioids, may help patients take fewer opioids more effectively.
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